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COPYRIGHT DEPOSIT. 



COLDS, COUGHS 
^ SORE THROATS 



THEIR CAUSE 
PREVENTION AND CURE 



WITH DIRECTIONS FOR 
HOME TREATMENT 



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BY 

WILLIAM CONYNGTON, M. D. 



New York 

The Ronald Press 

1906 



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Copyright 1906 

By 

The Ronald Press Company 



PREFACE. 

Reader, whoever you may be, this book is in- 
tended for you. That person does not exist, unless 
he be numbered among the very few who have 
never '' taken cold,'' and is likewise indifferent to 
suffering and inconvenience among his friends, who 
is not interested in its subject. 

There is not a school boy or girl who cannot 
understand how to apply the more obvious rules 
for the avoidance of those conditions which pre- 
dispose to colds; not a mother who cannot use the 
simpler methods of prevention and cure; not a 
business-man, farmer, lawyer, senator or horse- 
wrangler who will not do well to heed the cautions 
in regard to unnecessary exposure, improper cloth- 
ing, lack of ventilation, carelessness in eating and 
neglect of early symptoms. 

The primary object of the book is to tell in plain 
words why we catch cold, how to avoid the causes, 
how to check or break up the morbid process when 
acquired, and how to put the body in such a condi- 
tion of health that it will not readily take cold. 

In discussing medical treatment it deals only with 
remedies that can be safely, promptly and properly 
used at home, and these it explains fully and clearly 
so that there need not be the slightest difficulty in 



11 PREFACE. 

their application. Colds and coughs, with a few 
well-marked exceptions, come on by rather slow 
degrees. There is no sudden outbreak, but mild 
symptoms make their appearance, gradually increas- 
ing in severity until the disease is fully developed. 
This mild commencing period is the golden oppor- 
tunity for home treatment. As a few drops of 
water will quench a fire when just starting, so a 
very small amount of treatment, promptly adminis- 
tered at this critical time, will frequently check the 
disease so that it never gets beyond the initial stage. 
When, however, such a disease does begin with 
much severity, or refuses to yield to simple reme- 
dies, or for any other reason seems unsuited for 
home treatment, a physician should be sent for 
without delay. 

The first part of the book contains a brief de- 
scription of the respiratory tract; a consideration 
of the anatomical and physiological changes in- 
volved in the process of " catching cold," and a 
discussion of bacteria, together with the general 
subject of infectious and contagious diseases. The 
medicinal remedies and their doses, and the simple 
apparatus used in the treatment of afifections of the 
respiratory tract are also considered. 

The second part is devoted to the consideration 
of the diseases to which the respiratory tract is sub- 
ject. The causes, symptoms and treatment of the 
simpler forms are discussed at length; the more 



COLDS^ COUGHS AND SORE THROATS. Ill 

dangerous affections are discussed with such ful- 
ness as to secure their early recognition, and, as a 
result, their prompt treatment at the hands of a 
competent physician. In all cases the work tries 
to make plain when professional advice is needed, 
and, when it is needed, the importance of calling 
in a doctor before harm, perhaps beyond the possi- 
bility of repair, has been done. 

And finally, a short section is devoted to the more 
general principles of hygiene; the methods of se- 
curing the necessary sunshine, fresh air, exercise 
and rest ; the importance of applying common sense 
to the affairs of daily life so as to make the most 
of its opportunities for health and exercise, and, 
generally, the necessity of taking an interest in life, 
thereby making life interesting, and as a conse- 
quence more healthful and better worth living. 

William Conyngton, M. D. 

Washington, D. C, 
September i, 1906. 



COLDS, COUGHS AND SORE 
THROATS. 



TABLE OF CONTENTS. 

PART I. PRELIMINARY CONSIDERATIONS. 

Chapter. Page. 

I. The Respiratory Tract and Its Diseases... 7 

II. Causes of Colds, Coughs and Sore Throats.. 23 

III. Bacteria and Their Relation to Disease... 45 

IV. Infectious and Contagious Diseases and 

Their Causes 6s 

V. Apparatus Used in Treatment of Respira- 
tory Diseases 76 

VI. Medicinal Remedies and Their Doses 88 

PART II. RESPIRATORY DISEASES AND THEIR 
TREATMENT. 

VII. Cold in the Head 104 

Coryza; Acute Nasal Catarrh; Acute 
Rhinitis. 

VIII. Sore Throat (Common Forms) 129 

Naso-Pharjmgitis; Adenoids; Pharyngitis; 
Laryngitis. 

IX. Sore Throat (Severe Forms) _. . 142 

Diphtheria; Membranous Croup. 

X. Sore Throat (Severe Forms) 159 

Tonsillitis. 

V 



VI 



TABLE OF CONTENTS. 



Chapter. Page. 

XI. Cough (Cold on the Chest) i66 

Bronchitis. 
XII. Cough (Cold on the Chest, Severer Forms) 179 
Pneumonia; Broncho-Pneumonia; Pleurisy. 

XIII. La Grippe or Influenza 197 

XIV. Hay Fever 207 

XV. Whooping Cough. (Pertussis.) 211 

XVI. General Treatment 218 

Constipation; Diarrhoea. 

XVII. General Treatment 227 

Fever. 

PART III. HYGIENE. 



XVIII. Fresh Air and Sunshine 235 

XIX. The Food We Eat 248 

XX. Exercise 256 

XXI. Clothing, Bathing and Sleep 269 

XXII. Conclusion and Conclusions 278 



COLDS, COUGHS AND SORE 
THROATS. 



PART I. — Preliminary Considerations. 



CHAPTER I. 

The Respiratory Tract and Its Diseases. 

The very common and very annoying disease 
conditions popularly known as colds, coughs and 
sore throats, are met with in every family, and in 
the majority of families they occur many times in 
the course of a year. The conditions dealt with 
in this book are all of the acute type; that is, they 
come on with some degree of suddenness, and they 
are all affections of the respiratory tract; that is, 
of those inner portions of the head, neck and chest 
which take part in respiration or the act of breath- 
ing; hence if the book were principally or entirely 
intended for the reading and study of physicians 
and medical students it might very properly be 
termed ''Acute Diseases of the Respiratory Tract.'' 

7 



8 COLDS, COUGHS AND SORE THROATS. 

Its main object, however, is to furnish a convenient 
volume for home use, giving wherever possible 
plain, honest English words in preference to 
more technical terms, and for this reason the ordi- 
nary household words *'Colds, Coughs and Sore 
Throats" are chosen to form its title. As all of 
these conditions are more or less directly connected 
with the respiratory tract, a few words will be here 
devoted to the consideration of this part of the 
body. 

The respiratory or breathing tract, consists of 
the air channels of the nose and throat, the wind- 
pipe and all of its branches, and the microscopically 
small air cells of the lungs. All are lined or cover- 
ed with delicate velvety tissues, the mucous mem- 
branes, which serve the purpose of an internal skin, 
and are kept moist and to some extent protected 
by their own secretion of mucous. 

The air channels of the nose form an admirably 
effective apparatus for purifying and preparing the 
inspired air for further progress to, and final useful- 
ness in the air cells of the lungs. A number of 
short hairs at the entrance form a partial screen 
through which the air is drawn, after which it is 
whirled and twisted about, in and through the curi- 
ously-shaped nasal passages, in such wise that it is 
brought into most intimate and thorough contact 
with the warm, moist membranes, which in this 
location are peculiar in the great number and large 



THE RESPIRATORY TRACT AND ITS DISEASES. 9 

size of blood vessels lying just beneath their sur- 
faces, while the somewhat labyrinthine arrange- 
ment of the internal nasal walls increases the amount 
of surface and prolongs the time of transit. The 
structure of these membranes favors a rapid trans- 
fer of warmth and moisture from the large and 
constantly changing blood current to the entering 
air, and so well are these offices performed that the 
entire quantity of inspired air is saturated with 
moisture and warmed to the normal bodily tem- 
perature before reaching the deeper and still more 
delicate tissues. It is also claimed that a large 
proportion of those injurious germs which are so 
commonly found in the atmosphere are retained 
and finally destroyed and thrown off by this same 
useful old nose. When the nose is stopped up, as 
by a cold in the head, or when from bad habit, 
mouth breathing is indulged in, the inspired air is 
only partially warmed, moistened and otherwise 
prepared for contact with the deeper tissues, and 
diseases of the throat, windpipe or lungs are very 
apt to develop as a consequence of such misfortune. 
The inspired air passes from the cavities of the 
nose into the throat, which comprises, according to 
the ordinary usage of the word, the pharynx and 
larynx. The pharynx is much the larger portion 
and extends from the nasal openings to the larynx 
and oesophagus. It is divided into the naso- 
pharynx, oro-pharynx and laryngo-pharynx, bult 



lO COLDS, COUGHS AND SORE THROATS. 

the divisions are much hke those of latitude and 
longitude on the earth's surface; that is to say, 
they are imaginary lines laid down on an unbroken 
surface. 

The naso-pharynx (nose part of the throat) is 
above and behind the mouth, reaching much higher 
than is usually realized, so that we have here quite 
a large concealed cavity. The nasal cavities open 
directly into it and a little behind these openings 
and at the sides the Eustachian tubes pass to the 
middle ear cavities, each tube supplying air to the 
middle ear of that side and regulating pressure on 
the tympanum or ear-drum. The Eustachian tubes 
are of considerable importance in considering dis- 
eases of the throat, as inflammation often reaches 
the ear through these channels and at other times 
they may be closed by swollen tissues or blocked by 
increased secretions, giving rise in either case to 
various disorders of hearing or diseases of the ear. 
Lymphatic glands are found in considerable num- 
bers in the deeper layers of the walls of the naso- 
pharynx and their overgrowth causes the very 
harmful condition of adenoid hypertrophy. (See 
Part II, Chapter VIII.) 

The oro-pharynx (mouth-pharynx) is that part 
lying behind the mouth and extending forward to 
the soft palate. It includes the part of the throat 
visible from the outside when the mouth is widely 
opened and afifords passage for food from the 



THE RESPIRATORY TRACT AND ITS DISEASES. II 

mouth to the oesophagus as well as for air from 
the upper throat to the larynx. The soft palate 
and tonsils are anatomically a part of the mouth, 
but as inflammation of these parts gives a severe 
sore throat they will be considered in connection 
with throat troubles. The laryngo-pharynx com- 
prises those portions of the throat adjacent to the 
larynx and oesophagus. 

The larynx lies between the pharynx and trachea 
or windpipe. It is a box-like structure composed 
of plates of cartilage, ligaments and muscles, and 
contains the parts by which the voice is produced. 
Its largest plates of cartilage form the most prom- 
inent part of the external throat in the midline, 
commonly known as the ''Adam's apple.'' The 
uppermost part is the epiglottis, a very effective 
and snug-fitting lid, composed of cartilage and 
membranes, opening freely and widely in speaking 
and breathing but closing tightly when food or 
liquids are swallowed, while at the same time the 
whole larynx is drawn forward and upward under 
the root of the tongue. 

The larynx opens into the trachea or windpipe, 
which is a cartilaginous tube about three-quarters 
of an inch in diameter, extending downward three 
and a half to four and a half inches as a single 
tube. At this point it divides into the right and 
left bronchi, and these bronchi rapidly divide and 
subdivide until the finest bronchioles (little bronchi) 



12 COLDS, COUGHS AND SORE THROATS. 

terminate in the minute alveoli or air-cells of the 
lungs. 

A cold, as ordinarily understood, means a catar- 
rhal inflammation affecting one or more of those 
internal portions of the body which are concerned 
in the act of breathing, and is frequently although 
not always brought on by exposure to cold. All 
of these internal parts of the body over or through 
which the inspired air passes, are lined or covered 
with mucous membranes which in health continually 
secrete a sufficient quantity of mucous to keep 
themselves moist and protected from direct con- 
tact with the inspired air and whatever it may 
contain. Catarrhal signifies a condition in which 
these secretions are so increased in amount as to 
clog the air passages by their quantity, and so 
changed or perverted in character that they become 
injurious and improper substances for retention in 
the body, hence they are gotten rid of by blowing 
the nose, coughing and spitting. 

A sore throat is any condition in which there is 
pain and irritation in or about the internal throat, 
and as these conditions are almost always accompa- 
nied by some degree of inflammation and increased 
and perverted secretions, and are also frequently 
brought on by exposure to low temperatures, they 
too are called colds. More commonly such a con- 
dition is referred to as "a cold and sore throat," 
and as this covers all of the disease conditions 
found, it is perhaps preferable. 



THE RESPIRATORY TRACT AND ITS DISEASES. 1 3 

A cough signifies the violent and noisy expulsion 
of air from the lungs, owing to some cause of irri- 
tation affecting the membranes of the lower air 
passages, or some nerve or nerves connected with 
them. The commonest cause is, of course, the in- 
creased and perverted secretions, for getting rid of 
which coughing is the natural and effective means. 
Another common factor is some swollen portion of 
the respiratory tract which partially closes an air 
channel, interferes with other parts, or presses on 
some nerve. 

At times, however, coughing is caused by dis- 
orders in parts of the body entirely distinct from 
the breathing apparatus, as by stomach disturbance, 
or by some improper and irritating object lodged 
in the external ear. The great vagus (vagabond 
or wandering) or pneumogastric (lung-stomach) 
nerve supplies a large part of the respiratory tract 
and is also the chief nerve of the stomach, hence 
irritation of the stomach terminals may be referred 
to some part of the throat or windpipe and result 
in coughing. Or, the trifacial nerve (three-branch- 
ed nerve of the face) may carry an impulse from 
an irritated ear over to the nose or throat, of suffi- 
cient strength to knock the wind out of the lungs 
by a good strong cough. 

The one term ''Colds'' is often used to include 
all of the conditions above referred to, and it is 
not at all uncommon to hear such a conversation 



14 COLDS, COUGHS AND SORE THROATS. 

as the following, between distant but friendly neigh- 
bors: "Hello, John! How's all the folks?'' to 
which John replies, "Just tolable to middlin', Henry. 
Mandy's been havin' a cold in her head most all 
the winter ; the girls has been havin' theirn in their 
throats, and Peter, he's had the worst cold on his 
chest since the war." The phrase "cold on the 
chest" is commonly used to designate bronchitis, 
but it is also applied to the graver conditions of 
pleurisy and the pneumonias. 

Besides the colds already referred to, certain 
other conditions such as la grippe, whooping cough, 
hay fever and diphtheria, usually classed under other 
headings, are considered in the present volume, for 
the reason that in some of their forms, or at some 
stage of their development, it is itnpossible to dis- 
tinguish them from diseases which are unhesitating- 
ly classed as colds. A mild case of the respiratory 
type of la grippe, and a severe cold in the head 
with extension to throat and upper chest, call for 
a trained bacteriologist with a good microscope to 
tell the difference ; whooping cough is a cough both 
by name and by nature ; hay fever is almost a dupli- 
cate of other colds, and diphtheria was formerly, 
and for very sufficient cause, known as putrid sore 
throat; and for these reasons they all seem to fall 
very naturally and properly under the heading of 
"Colds, Coughs and Sore Throats." 

In all of the diseased conditions referred to, with 



THE RESPIRATORY TRACT AND ITS DISEASES. 1 5 

the single exception of hay fever, two ideas are 
always popularly prominent. One is that some por- 
tion of the delicate membranes of the respiratory 
tract, together with more or less of the underlying 
structures, is congested or inflamed, the arteries, 
capillaries and veins engorged with blood, and the 
tissues swollen with serum and other constituents 
of the life fluid which have escaped from their 
proper channels, and that this congestion or swell- 
ing, together with the consequent tenderness and 
pain, causes more or less irritation and inconveni- 
ence in the act of breathing. And this first idea is 
strictly correct. 

The other idea is that this condition is caused, 
either wholly or in part, by low temperature, and 
from this idea the name "cold" is derived. This 
belief is only partially true, and so far as absolute 
cold is concerned, there is nothing to it at all, unless 
exposure is unduly prolonged. You may freeze a 
man's ears, his hands or his feet, or all of them, 
without his catching cold, and the same man may 
easily catch cold with the thermometer well above 
the freezing point. What will give him cold is to 
chill one part of the body more than other parts 
usually no better protected, hence the danger of 
cold drafts, getting the feet wet and so on. 

Absolute cold, to a robust person, is for a time 
much of a tonic and stimulates the heat producing 
centers to greater activity. But when such exposure 



l6 COLDS^ COUGHS AND SORE THROATS. 

is extreme and long continued, the bodily organism 
fails to react fully, the individual becomes "chilled 
through,'' and the superficial circulation is largely 
checked. Under these circumstances, cold becomes 
one of the very depressing forces, lowers vitality, 
puts the mucous membranes into the finest possible 
shape for bacterial proliferation and activity, and 
the end of the process may be a severe cold, that 
is to say a catarrhal inflammation of nose, throat 
or chest. 

Damp cold is far more depressing and much more 
likely to result in colds and kindred affections than 
a temperature low enough to freeze the moisture 
out of the air, giving what is called "dry cold." 
Hence we catch cold with the greatest ease and 
frequency when the temperature is barely above 
freezing and full of moisture, as in a cold, slow 
thaw, when melting snow and ice keep the dense, 
sodden atmosphere saturated with moisture to the 
fullest limit of its capacity. 

Hay fever is the only cold that is not associated 
with low temperature either by actual relationship 
or popular belief. It is caused by some form of 
pollen or other vegetable dust and necessarily comes 
at that time of the year when the plant (be it rose, 
rag-weed, golden-rod, or other weed or flower) that 
furnishes the poisonous substance arrives at the 
proper stage of development to scatter the causative 
dust. 



THE RESPIRATORY TRACT AND ITS DISEASES. 1 7 

Home treatment is proper in many forms of 
respiratory diseases. Very frequently an ordinary 
cold in the head, a mild sore throat, or a cough of 
moderate severity, is not considered of enough im- 
portance to justify sending for the doctor, and yet 
these ailments cause much discomfort and annoy- 
ance, and if neglected may lay the foundations for 
more dangerous diseases in the future. These are 
the forms that are strictly suitable for home treat- 
ment. At home they can be noticed and taken in 
hand at the very beginning, and at this stage they 
usually yield readily and completely to comparative- 
ly simple and easy treatment. And if from tardi- 
ness in recognizing and treating such a condition, 
or from unusual severity of the attack, it fails to 
yield completely, the illness is so shortened, the 
discomfort so mitigated and the general health so 
much less disturbed, that all of the time and trouble 
so expended is vastly more than paid for. And 
again, there is no shadow of doubt but that prompt 
attention to what was deemed a simple cough or 
cold has frequently checked some disease process 
that would have developed into a dangerous or fatal 
illness if left to run its course. 

Other cases in which home treatment is most 
absolutely proper are those where no doctor can be 
obtained. Some of our readers will smile at this 
statement and remark, "Well, this doctor has his 
imagination with him for sure. Such things might 



l8 COLDS^ COUGHS AND SORE THROATS. 

have been a century ago, but not by a jugful in this 
day and generation." Nevertheless it is a fact that 
people, and not a few of them either, suffer and 
die without medical care in this very year of Grace, 
A. D. 1906, some of them because a medical prac- 
titioner cannot be found within a hundred miles or 
more, others because they prefer to take chances 
rather than to ride ten, fifteen, or fifty miles and 
pay anywhere from ten to three hundred dollars for 
medical attention that is frequently far from first- 
class. And in all of the cases falling under either 
of these classes it is very desirable that some knowl- 
edge of the commoner forms of disease should be 
at hand, with simple directions for treatment that 
can hardly do harm any way it is applied, while the 
chances of its doing much good are many and 
large. 

When, then, should a doctor be called? Where 
a good physician is within easy reach and the dis- 
ease condition is at all severe, call in your doctor 
without hesitation, and if in doubt as to whether 
the case is within your ability or a little too much 
for home medication, err on the side of safety and 
send for the physician. A good doctor is a bless- 
ing to any community, earns every cent he ever 
gets and a very great many that he never gets, and 
if any man deserves patronage and encouragement 
it is the physician. Hence if he earns a fee where 
it might have been saved by taking extra risk and 



THE RESPIRATORY TRACT AND ITS DISEASES. 1 9 

unnecessary trouble, do not begrudge it or consider 
it so much to the bad ; neither for paying him what 
you justly owe look for a reward from heaven. 
That rather belongs to the big-hearted old doctor 
who loses his rest in this wicked world that others 
may enjoy theirs during health and prosperity, with 
the well-founded assurance that in time of need 
they can depend on the medical man's keenest 
watchfulness and most skillful care, freely given 
up to such limits that he has to prop his eyes open 
to keep awake, or drops in his tracks from sheer 
inability to stand up any longer. May blessings 
light on every good and honest doctor's head, and 
down to the deepest depths with all the bad ones, 
with a millstone tied to every evil neck. 

Another object of the present work is to give 
instructions as to the avoidance and prevention of 
colds. The story is often told of a recipe in an 
old time cookbook for preparing hare soup for an 
invalid, commencing with the proposition, "First 
catch your hare." If no hare is caught, of course 
the preparations cease right there, and it is the 
same way with a cold ; if no cold is caught no treat- 
ment is needed, and everybody will agree that this 
condition is preferable to the finest of treatment 
after the cold is caught. 

Something about the causes of colds and how 
to avoid them we all know, but we do not know 
enough, and what we do know we do not properly 



20 COLDS, COUGHS AND SORE THROATS. 

apply. 'It is a little damp," says the young lady, 
'*but it will not hurt me to just run around the corner 
in my slippers," and round the corner she goes and 
presently her head is going round too, and the next 
laundry bill is larger by some dozen or two of dainty 
handkerchiefs. ''Oh, well," says the Congressman, 
"it used to give me indigestion and a cold to eat 
lobsters, but lobsters elected me and I reckon they'll 
treat me better this time," and so the lobsters have 
their revenge. 

And again, while it is generally recognized that 
getting the feet cold or damp, and indigestion, are 
very common exciting causes of colds, there are 
other less commonly understood causes that are just 
as efficient, such as sitting or kneeling in a cold, damp 
church through a long prayer or sermon, mouth 
breathing, wearing too much or too heavy clothing, 
and going from the hottest part of a hot room to 
colder outside air, or vice versa. And the fact that 
many of the commoner colds, as well as diphtheria, 
consumption and whooping cough, are readily 
transmitted from person to person, usually through 
breathing the air contaminated by the coughing or 
sneezing of the victims of such disorders, is not by 
any means properly appreciated. Neither is it at 
all realized what an efficient means of spreading 
infection our public conveyances are, especially 
when heavily upholstered, as even the street cars of 
the present day frequently are. How often does 



THE RESPIRATORY TRACT AND ITS DISEASES. 21 

it happen that in a crowded street car the victims 
of consumption, or sufferers from milder respira- 
tory disease, keep up a constant coughing or sneez- 
ing, without even dreaming of screening the moutb 
with hand or handkerchief, although every cough 
or sneeze sends the disease germs flying for several 
yards. What chance then has the weakly individual 
right across the narrow aisle and in direct range of 
this volcanic eruption of dangerous germs. Or sup- 
pose a victim of tuberculosis has the car to himself ; 
what a fine ambush the cushioned seats form, and 
how freely the microbes will be spread throughout 
the car in its rattling, shaking travels, when they 
are brushed and rubbed from the cushions by every 
passenger who does not have to stand. 

And yet one step further: such a condition of 
physical health and vigor that ordinary causes of 
disease are harmless as so many drops of water 
on a duck's back is the ideal state of affairs. Un- 
fortunately this is a better condition than most of 
us can possibly attain to, notwithstanding which it 
is worth much effort to approximate it; hence a 
portion of the present book will be devoted to a 
consideration of the means by which we may so 
use whatever advantages are at our command as 
to increase our bodily health and vigor, which is 
the first and greatest thing to be desired. The next 
object is to avoid so far as possible all recognizable 
causes of ill health. If both of these precautions 



22 COLDS, COUGHS AND SORE THROATS. 

fail us, as they sometimes will, and a cold, cough or 
sore throat is caught in spite of all our care, the 
next thing is to secure the simplest and most effect- 
ive treatment possible, whether it require the pres- 
ence of a physician or whether it fall within the 
scope of home treatment. And if home treatment 
is decided on, while always striving to do all the 
good you can, let the old doctor's parting words 
to his graduating class, ''Young gentlemen, if you 
do no good be sure you do no harm,'' remain with 
you and be a cardinal principle in all parts of your 
home treatment. 



CHAPTER II. 
Causes of Colds^ Coughs and Sore Throats. 

Everything in this wicked world has a cause and 
a result, and colds, coughs and sore throats are no 
exception to this general rule. Every disease has 
some cause although our ignorance thereof may be 
profound, and every disease has certain results of 
which our knowledge is usually pretty full and com- 
plete. And as these results are, as a rule, far from 
agreeable or desirable, our knowledge thereof should 
lead us to seek out and avoid the causes with an 
earnestness proportionate to our dislike for the 
results. 

It is customary to divide the causes of disease 
into predisposing, or those which merely lower vital 
resistance and put the body into such shape that it 
may readily fall a prey to sickness, and exciting 
causes, or those which actually start the disease 
processes and determine their character. But this 
division, in our present condition of knowledge or 
lack of knowledge, can never be mathematically 
exact and positive, and while some causes must al- 
ways be regarded as predisposing and others just 
as certainly exciting, there are a number that hover 
in a debatable land, sometimes being classed under 
the one heading, sometimes under the other. And 

23 



24 COLDS, COUGHS AND SORE THROATS. 

again, circumstances may easily be such that an 
exactly similar cause is at one time, or to one person, 
merely predisposing, while at another time, or to 
another person, it is actively exciting. For instance, 
a forced march through sleety rain and freezing 
mud, to some of the seasoned veterans, will ap- 
parently be no more than a temporary source of 
discomfort and grumbling, but in a large proportion 
of the soldiers it will markedly lower vitality and 
predispose to disease, while to many it will be the 
exciting cause of pneumonia, pleurisy, rheumatism, 
or other form of disease. 

The most reasonable and useful division, and 
that which will be adhered to in this book, is to con- 
sider those factors which have to do with methods 
and habits of life, are prolonged in action and slow 
to produce results, as predisposing causes, while 
those which are of brief duration and quickly fol- 
lowed by ill effects are accounted as the exciting 
ones. 

Lowered vitality is often given as the greatest 
of the predisposing causes of ill health or disease. 
It is really a condition of the body brought about 
by the action of one or many predisposing causes, 
as lack of exercise, neglect of fresh air and sun- 
shine, worry, overwork, indigestion, — in short any- 
thing that decreases the bodily vigor and health, 
and it may be regarded as a sort of common center, 
or a halfway station on the road from health to 



CAUSES OF COLDS^ COUGHS^ ETC. 25 

disease, to which all other predisposing causes tend 
and from which the exciting causes find their most 
favorable starting point. 

Those early stages of life known as infancy and 
childhood are rightly placed in the front rank of 
predisposing causes. The tender little bodies have 
in themselves small power of resisting adverse in- 
fluences, experience is lacking and reasoning powers 
undeveloped. Nature's provision for this period of 
helplessness is the care and wisdom of the parents, 
but while the care is ungrudgingly bestowed, wis- 
dom and education along these lines are frequent- 
ly most woefully deficient, and the young human 
being has a poorer outlook as to health (although 
better as to mere existence) than the offspring of 
any other free animal. 

Old age and a fairly high degree of vitality are 
not inconsistent, but this combination is the rare 
exception and few who live the civilized life can 
hope to attain it. Lowered vitality and feebleness 
of the physical frame are the usual characteristics, 
and they are only partially compensated by the 
wisdom of experience and the less active and more 
protected life ; hence old age is a potent predisposing 
cause of various forms of disease. 

Neglect of fresh air and sunshine is a very 
common predisposing cause. "Something for noth- 
ing'^ has been the swindler's most alluring and ef- 
fective bait in all ages, and thousands hasten to 



26 COLDS, COUGHS AND SORE THROATS. 

his toils in the vain expectation of securing some- 
thing, it matters not how tawdry, without rendering 
an equivalent. But while thousands strive after 
these transparent frauds, milHons hasten with even 
greater eagerness to shut themselves off from the 
most vital necessities of life, the golden luxuries of 
fresh air and sunshine, which are not only absolute- 
ly free, but are so forced on us that it is only 
by the most skillful devices of civilization that we 
are able to keep away from them at all. The coun- 
try boy spends most of his waking hours out of 
doors and he can wade through melting snow all 
day, with feet soaking wet and cold as ice, and 
not take cold. Many of us cannot be out of doors 
all day, but most of us could be out for hours in- 
stead of minutes if we chose. How many a neu- 
rasthenic clerk pays five cents for the privilege of 
riding in a stuffy street car so that he may spend 
an extra half-hour of his own private time in a 
dingy office reading sensational newspapers or 
trashy novels, when a brisk walk down town would 
not only give him sunshine and what of fresh air 
the city affords, but also add a third great requisite 
of health, a moderate amount of vigorous exercise 
to stir the sluggish heart and torpid liver. In the 
evening another nickel saves him from exercise, 
sunshine and fresh air, and he is able to get indoors 
again with the smallest possible exposure to these 
life-giving influences. But now at night, with base- 



CAUSES OF COLDS, COUGHS, ETC. 2/ 

burning stove and plenty of bedclothing if it be 
winter, surely this cringer from sunshine will throw 
the windows wide open and let the fresh air do him 
some modicum of good. Will he? If the night 
air were the deadliest miasma it could not be more 
carefully shut out than is often done by people who 
by all rights of education ought to be thoroughly 
posted as to the value of fresh air, and so they roll 
and toss in uneasy, restless slumber and awaken 
unrefreshed for the duties of another day. 

In winter time the Indians of the Northwest, 
those erstwhile hardy warriors of the Little Big- 
horn, retire into their houses, low log cabins, chink- 
ed with mud and roofed with sod, and there with 
stove red hot and door and windows closely shut, 
they are as tightly and as hotly boxed as any of 
their civilized brethren, and breathe an atmosphere 
even more confined and vitiated than our own. 
And they die with consumption as sheep with the 
rot. When warm weather comes they move out 
into their tents and in a few days the reservation 
doctor, who has scarcely had time to eat and sleep, 
wonders where all the sick Indians are. If it were 
not for this tenting business the Indian question 
would exist only in history. 

Lack of exercise is a potent predisposing factor 
of disease. Exercise, proper in kind and moderate 
in quantity, is a sine qua non for the maintenance 
of high vitality. How many of our city people 
pay any attention to it? It goes hand in hand 



28 COLDS, COUGHS AND SORE THROATS. 

with fresh air and sunshine, like them it is to be 
had for the taking, and Hke them it is avoided 
by means of the ready street car. A brisk morning 
walk to the ofifice and a more leisurely return when 
the day's work is done would be worth tens of mil- 
lions of dollars annually to those of our office work- 
ers who live within a mile or two of their places 
of business. The clerk who rides a bicycle not only 
saves car fare, more than enough to pay for his 
wheel, but also secures somewhat of exercise, sun- 
shine and fresh air, and when, as often happens, 
he is tempted to use his wheel and part of the time 
at his own disposal in exploring the surrounding 
country or in other out-of-town rides, he is nearing 
a satisfactory solution of the problem of higher 
vitality. 

In country life these conditions are apt to be 
reversed and over-exertion and too much exposure 
also predispose to disease. Instead of too little 
out-of-doors air, sunshine and exercise, there is 
more than likely over-exposure, and exercise is fre- 
quently carried beyond the limits of healthful en- 
durance. These ills are not the result of ignorance, 
but are regarded as unavoidable evils, necessarily 
undergone and submitted to as a means of bread- 
winning. Here the remedy is better methods of 
farming, raising more of the home necessities, 
studying the markets and selling at favorable times 
— in short, more wisely converting mind and muscle 
into cash or the things that cash will buy, so that 



CAUSES OF COLDS, COUGHS, ETC. 29 

bodily vigor is no longer bartered for the wages of 
a galley slave while the mind rusts for the want of 
healthful exercise or is worn to a frazzle by dis- 
contented repinings. 

In the matter of diet it is doubtful if we err as 
much as is generally claimed. A horse in pasture 
eats as much or more than one that is working, 
but his food is not so highly nutritious and he has 
plenty of fresh air, sunshine and exercise. Neglect- 
ing these three great essentials we cannot make up 
for them by cutting down rations. Certainly if we 
are going to lead a strictly sedentary life its evils 
may be lessened by some reduction of diet, but it is 
better to get hold of this problem by the other end ; 
eat plenty of suitable food and turn it into good 
rich blood by out-of-doors exercise. Suitable food 
is a far better key-note than any material reduction 
in quantity. The northern lumberman smiles 
broadly over a huge plate of pork and beans swim- 
ming in molasses, with plenty of potatoes, biscuits 
that are sometimes very heavy, and an abundance 
of strong black coffee. The ofifice man who at- 
tempted this meal might smile on the other side of 
his face before the day was done, but that is no rea- 
son why he should rise hungry and with an aching 
void just below his heart from a scanty bowl of 
breakfast food and a cup of imitation coffee. There 
is a golden mean in all these matters and each man 
should be his own best adviser as to what food 



30 COLDS, COUGHS AND SORE THROATS. 

articles give him the best results in the way of 
health and a capacity to work and to enjoy life. 

Diet rules may be given you by the hundred, 
many of them not worth the paper they are written 
on, but the one safe and practicable rule is to regu- 
late your own diet, both as regards quantity and 
quality, by your own careful observation as to the 
effect of what you eat. If sliced cucumbers, toasted 
cheese and ice cream do not comfortably adjust 
themselves to each other and to your own internal 
economy, why, '*Take the one that you like best," 
if by itself it agrees with you, and let the others 
go; until next time, anyhow. If you know that 
pickles give you colic you deserve colic if you eat 
them. A dyspeptic friend (a clerk, not a lumber- 
man) walked complainingly down the street with 
me one day at noon to get ''a little light lunch" 
that would rest easy and not give him a pain. He 
first ate a plate of buckwheat cakes with a cup of 
coffee, then a dish of beans with another cup of 
coffee, and finished with a large slice of mince pie. 
As we walked back he, still complaining, asked, 
''What do you suppose makes me feel so queer?" 
I told him it was because he had not topped off with 
a keg of ten-penny nails, whereon he got keenly 
angry, said I might think that was funny but there 
wasn't anything funny about it ; and maybe he was 
right, only it illustrates by way of contraries, the 
importance of using judgment in diet. 

Worry is yet another factor of lowered vitality. 



CAUSES OF COLDS, COUGHS, ETC. 3 1 

mainly artificial it is true, but still of mighty power. 
Man's mental activity cannot be suppressed and 
unless it finds legitimate exercise in some field of 
keenest interest, hunting, fishing, boating, poultry- 
raising, music, business, or other chosen pursuit, 
it is usually expended on imaginary troubles. 
Avoiding sunshine, abjuring fresh air and shrink- 
ing from physical exercise, the man finds vent for 
his misdirected energies in fretting and worrying, 
magnifying trifles, cultivating discontent and gene- 
rally making himself a nuisance of the first water, 
and this reacts directly on his health, i. e., lowers 
his vitality. That real causes for worry exist is 
not denied, but the real are to the imaginary as a 
glow worm in the grass to a battleship's searchlight. 

Hosts of office workers who are given to useless 
worry only need some out-of-doors pursuit in which 
they can take an absorbing interest to make them- 
selves practically different individuals, and the 
change would be a most agreeable surprise to them- 
selves as well as to their friends and associates. 
Look about you, brother, and see what your en- 
vironment and tastes allow in this line. Get a dozen 
Plymouth Rock chickens and go in for fine fowls, 
set out a flower bed or a vegetable garden, buy a 
bicycle and explore every nook and corner for forty 
miles or more; do something and take an interest 
in it and drive out the blue devils. 

But suppose a man is taking too much interest 
in something already, working all day and until 



32 COLDS^ COUGHS AND SORE THROATS. 

late at night at his business, with no more time for 
chickens, flowers or bicycling than the sun has for 
afternoon tea; or is bending every energy to the 
keen strife of politics, or in any other way is at- 
tempting to do more than any one man is capable 
of — what then? In that case he must simply take 
his choice between whatever he is so engrossed in 
on the one hand, and on the other some less exacting 
pursuit with more of health, comfort and all else 
that makes life worth living. If he persists in 
spending every available ounce of energy along one 
particular line he is in the same class as the con- 
firmed drunkard. 

Defective and poorly ventilated dwellings, of- 
fices and workrooms form another predisposing 
cause. The rooms and buildings in which we live 
and work for a large proportion of our lives are 
as yet very far from perfection or even a possible 
degree of excellence. In the horribly unsanitary 
sweat shops of the great cities, human health and 
life are simply disregarded, but in many costly and 
externally handsome buildings, ventilation is defi- 
cient, light often poorly supplied and the heat supply 
varies from depressing cold to debilitating warmth. 
The harsh, dry air of furnace-heated rooms plays 
havoc with the respiratory apparatus, defective light 
causes eye-strain with resulting headaches and nerv- 
ous disorders, and poor ventilation is one of the 
most effective means of lowering vitality and pre- 
disposing to all manner of disease. 



CAUSES OF COLDS^ COUGHS, ETC. 33 

Self-indulgence is another potent predisposing 
cause of lowered vitality. Immoderate smoking or 
chewing of tobacco, drunkenness and improper in- 
dulgence of the sexual propensities, all lower vitali- 
ty, and this fact is too well known to require more 
than a passing reference. In these matters it is 
the will and not the judgment that is at fault, and 
warnings by the thousand are useless if he whose 
interests are at stake sets intelligence aside and 
makes a hog of himself because he feels like it. As 
to the moderate use of alcoholic liquors and tobacco 
there is little to say, only be sure that your definition 
of moderate be not too liberal for your financial 
capacity or physical welfare. 

To summarize, we catch cold easily because our 
vitality is low, and our vitality is low because we 
are slothful and self-indulgent, because we neglect 
fresh air, sunshine and out-of-doors exercise, be- 
cause we eat, not for the purposes of health and 
strength, but at the dictates of an appetite spoiled 
by being allowed to rule where it should be under 
strictest control, and because we wear ourselves out 
in petty worrying w^hen the whole world is full of 
objects of worthy interest. 

As to those who are obliged to work in badly 
ventilated, insufficiently warmed and poorly lighted 
offices and workrooms, shop-girls with killingly 
long hours and miserably insufficient pay, and all 
others whose health is sacrificed to greed, we can 
at present only extend our sympathy to these vie- 



34 COLDS, COUGHS AND SORE THROATS. 

tims of avarice and express our detestation for the 
brutish employers. But when the time does come 
when we, the people, really have a voice in govern- 
ment ; when representatives really represent and sen- 
ators and judges are honest, whether from choice or 
necessity; — when this desirable condition of affairs 
does come to pass, let us see to it that taking ad- 
vantage of a man's (much more of a woman's) 
necessities to cut down wages to less than living 
rates, or to fit up workrooms without due regard 
to the health of the workers, shall be placed among 
the most keenly watched and most severely punish- 
ed crimes of our commonwealth. 

Exciting causes are those which actually start the 
disease processes and determine their character. 
The most generally recognized exciting causes of 
colds, coughs and sore throats are exposure to cold 
and dampness, bacteria or vegetable micro-organ- 
isms, mouth breathing (which in children is often 
associated with or brought about by the condition 
of adenoid hypertrophy), acute attacks of indiges- 
tion or other digestive disturbances, impure air or 
air containing irritant substances such as smoke, 
factory fumes, fine particles of steel, stone, wool 
or other substances used in the arts and industries, 
and the vegetable dusts causing hay fever and its 
kindred. 

At one time exposure to cold and dampness cover- 
ed the greater number of the recognized causes of 
colds, coughs and sore throats, but in the present 



CAUSES OF COLDS, COUGHS, ETC. 35 

day bacteria enjoy the distinction of being con- 
cerned in the majority of cases, sometimes as the 
sole exciting cause, oftener perhaps as increasing 
and prolonging the effects of exposure, inhaled ir- 
ritants or disturbances of the digestive and circula- 
tory systems. Very frequently two or more of these 
exciting causes act together to produce one form 
of cough or cold, as in bronchitis, where exposure 
causes a congestion of the bronchial mucous mem- 
branes which might be temporary and hardly severe 
enough to be called a disease were it not that this 
mild congestion favors enormous increase, both in 
numbers and virulence (power for evil) of the 
ordinarily harmless bacteria found in this locality, 
so that these combined factors, neither of which 
alone would be of much importance, cause a well 
marked condition of disease. 

Exposure to cold and dampness is one of the 
commonest exciting causes of cold. Getting the 
feet wet is a typical method of catching cold by 
exposure. A limited and sensitive part of the body 
is chilled (dampness has little effect without the 
chilling) while the rest of the body remains at its 
usual temperature, the circulation is unduly checked 
at this particular point, heat production and distri- 
bution are seriously interfered with, and somehow 
it results in a cold. 

Getting the feet wet is probably the commonest 
and most familiar of all the exciting causes. Speak 
of a cold and your hearer immediately thinks of a 



36 COLDS^ COUGHS AND SORE THROATS. 

cold in the head; speak of catching cold and he as 
quickly jumps to the conclusion that you have got 
your feet wet. Suppose you ask some street Arab, 
one of the newsboys for instance, *'Bud, what is the 
easiest way to catch cold?" and if the boy be in a 
friendly and communicative mood he will probably 
answer, ^'Go get your feet wet, you old guy, and 
you'll catch cold all right," and the boy has answer- 
ed well. Given the predisposing factor of lowered 
vitality and it is a most potent and efficient cause. 

Getting soaked to the skin, as by falling over- 
board from a boat, or encountering a sudden shower 
without sufficient protection is another mode, and 
it sometimes works very well even in summer time. 
Here the entire outer surface of the body is chilled, 
the blood is driven to the internal parts which have 
received no such shock, the circulation is grossly 
interfered with, and again we have a cold. But 
suppose the dampened party runs home, takes off 
his wet clothes, rubs himself into a glow with a 
coarse towel and puts on dry garments, perhaps 
even takes a nip of whiskey or similar excitant, 
what then? Why, if he has any amount of vitality 
at all he has knocked that particular cold most 
effectually out of commission. 

And in either of these cases, or similar ones, if 
the vitality is high enough to cause a vigorous re- 
action no cold occurs. The chilling, which is the 
real cause of the cold, contracts the blood vessels 
and drives the blood to the internal parts of the 



CAUSES OF COLDS, COUGHS, ETC. 37 

body. If reaction occurs an abundant supply of 
warm blood is hurried into the contracted vessels 
so that they are again filled and expanded and the 
part brought back to the normal temperature or 
even a little above it, the chilly feeling gives way 
to a warm glow, and the subject of the dampening 
feels better and more vigorous than before. If vi- 
tality is high you can remove your clothing, wade 
a good sized stream amid cakes of floating ice, then 
rub the exposed parts dry and warm with a towel 
or some outer piece of clothing, and go on your way 
without harm. If, however, vitality is not high 
enough to bring about vigorous reaction the parts 
remain chilled and a cold of some variety is almost 
sure to follow. 

Drafts of cold air which take effect on a limited 
part of the body are another frequent cause of 
colds. The neck, wrists and ankles are the parts 
commonly chilled by these causes. All of these 
parts are partially protected by clothing, and the 
amount of protection varies greatly according to 
the clothes worn, posture of the body and contact 
with chairs or other furniture. Shrinkage of under- 
garments is a frequent cause of undue exposure of 
wrists and ankles. Perhaps new underclothing is 
purchased at the beginning of winter and the pur- 
chaser rejoices in well protected wrists and ankles, 
but with each succeeding washing the protection 
is less, and by the time really bad weather arrives, 
from one to two or three inches of these sensitive 



38 COLDS^ COUGHS AND SORE THROATS. 

parts are inadequately protected and numerous un- 
accountable colds puzzle and exasperate the victim. 

Leaning from a window to carry on a conversa- 
tion with some one below is very apt to expose 
neck, chest and wrists unduly; somewhat similar 
methods of exposure are wearing a low-necked 
opera or ball dress and neglecting to add a shawl 
between dances or when sitting in some cooler part 
of the room; throwing off the coat or other outer 
garment for some short, sharp piece of work and 
not resuming it quickly enough when the work is 
ended; rolling up the sleeves and after getting the 
arms warm and wet as in washing clothes, going 
out in the cool wind to hang out the wash. All 
of these are likely to result in chilling beyond the 
power of reaction and are among the commoner 
modes of catching cold. 

The face and hands are habituated to exposure 
and trained to quick and complete reaction, hence 
a biting, frosty wind produces rosy cheeks and a 
feeling of exhilaration instead of a cold. 

To take a warm bath and then go out of doors 
on a cool day is a very effective mode of catching 
cold. The superficial blood vessels are expanded 
and a large amount of blood is drawn near to the 
surface and on exposure much blood is chilled, while 
the relaxation from the bath precludes vigorous re- 
action. If warm baths are taken in cool weather, 
and they certainly should be, the process should be 
undergone about bed-time or an hour or two should 



CAUSES OF COLDS, COUGHS, ETC. 39 

be spent in a comfortable room before risking ex- 
posure. 

Then there are days when the thermometer hangs 
persistently about the freezing point, maybe a few 
degrees above, maybe a trifle below, but not enough 
lower to freeze the dampness out of the air; any- 
how it is very chilly, the atmosphere is moisture 
laden, and a mean, searching kind of a wind takes 
every opportunity to make itself felt; if melting 
snow is on the ground the conditions are intensified. 
This is the greatest time of all to take cold without 
any apparent reason, and unless vitality is high and 
the circulation active, the out-of-doors exercise had 
better be brisk and brief, care be taken to put on 
overshoes and overcoat before any long exposure, 
and generally to be on guard. A vastly colder day 
will be much less apt to result in coryza or bronchi- 
tis. After nightfall on just such days you may 
sometimes see two or three hundred people lined 
up on a damp, chilly sidewalk waiting for a theater 
door to open. They are not ignorant negroes, nor 
Indians willing to barter life and health for any 
tinsel show, but well educated people, used to in- 
doors life, not trained to even moderate exposure, 
and hollow graveyard coughs ring out along the 
line, proving that the cold demon is getting in his 
work. No show on earth can possibly be worth 
this amount of exposure and these people are "old 
enufif, big enuff, and oughter knowed better dan 
to gone and done dat way." 



40 COLDS^ COUGHS AND SORE THROATS. 

Bacteria, those strange, omnipresent, vegetable 
micro-organisms to the action of which contagion 
and infection of so many kinds are due, are beheved 
to be an exciting cause of almost every kind of 
respiratory disease. La grippe, v^hooping cough, 
diphtheria and croupous pneumonia are each caused 
by its own particular variety of organism, and in 
these diseases it is fair to account these forms of 
bacteria as the exciting causes. In other respiratory 
diseases, as coryza, bronchitis and several forms of 
sore throat, the bacteria are there and take an active 
part in the disease process, but no particular form 
is necessarily present and they remain harmless and 
inactive until exposure or other cause starts the 
condition. Yet the disease would not fully develop . 
without them, so here it would perhaps be proper 
to account the bacteria a secondary exciting cause, 
while exposure or other factor that actually started 
the process may figure as the primary exciting 
cause. There are still other diseases, notably ton- 
sillitis, which are believed to depend on some kind 
of bacterial activity but in which no special causa- 
tive organism has as yet been detected, and these 
we must be content for the present to designate as 
doubtful. 

The ill effects of breathing through the mouth 
have been explained in Chapter I. There is no 
doubt that laryngitis, bronchitis and catarrhal pneu- 
monia are frequent results of this bad habit. Some- 
times it is merely a habit ; in children it often results 



CAUSES OF COLDS, COUGHS, ETC. 4I 

from adenoids, and in other cases it depends on 
other obstructions in the nasal passages, such as 
polypi, the presence of a foreign body, malforma- 
tion of the parts, or some unrecognized disease 
condition. When merely a habit it may be cured 
by persistent training and a bandage about the jaw 
and head at night, but before going to this length 
with a child it should be definitely ascertained that 
healthful and easy breathing through the nostrils 
is possible, otherwise harm may be done rather than 
good. Nasal polypi or adenoids are to be removed 
by surgical procedure, and any other disease con- 
dition should be properly treated before success in 
breaking up the habit need be expected. 

That indigestion and constipation are sometimes 
classed among the exciting causes of respiratory 
diseases will be news to some of our readers; the 
experience of others will lead them to accept this 
view very readily. That either condition disturbs 
the circulation is sure, whether they be exciting 
causes or merely a part of the symptoms of the dis- 
ease. Some physicians go so far as to claim that a 
cold never occurs unless these disorders are present. 

Impurities of inspired air may cause respiratory 
diseases. To external irritants in the inspired air 
some people are very susceptible, others almost in- 
different. Some unfortunates promptly take cold 
on their return from a country vacation to the less 
pure, dust-laden atmosphere of the town or city, 
others are affected by some particular drug odor, 



42 COLDS, COUGHS AND SORE THROATS. 

or fumes from furnaces and factories, while still 
other people require much of any of these irritants 
to produce unpleasant symptoms. Among the more 
susceptible individuals may be classed the hay fever, 
or rose-cold sufferers. At the time that some par- 
ticular flower or weed scatters its pollen or other 
vegetable dust, they can confidently anticipate a 
period of the most intense wretchedness, and noth- 
ing but removal to some locality where the irritating 
substance is not found seems to avail, either in the 
way of prevention or of cure. To the question, 
"How would you treat a case of hay fever?'' a 
medical student once answered, "First remove the 
patient," this being a word-play on the time-honor- 
ed phrase, "First remove the cause," and the pro- 
fessor approved the answer as the best that could be 
given. The singular fact that these patients can 
often tell to a day just when their troubles will 
begin renders this mode of treatment both possible 
and practicable. Certain of the newer remedies 
do afford much relief, and vigorous claims are made 
for an antitoxin designed to give immunity and 
said to have been used with success in a large pro- 
portion of the cases experimented on. It is cer- 
tainly to be hoped that this stubborn and annoying 
complaint may finally be brought into subjection. 

Respiratory diseases are in some cases ascribed 
to unknown constituents of the air. At times some 
form of respiratory disease, which for a number 
of years has been almost unknown or of very mild 



CAUSES OF COLDS^ COUGHS^ ETC. 43 

degree, will rage with so much violence and break 
out almost simultaneously at such widely distant 
points, that the theory of changed atmospheric con- 
ditions has been discussed by our ablest and most 
conservative investigators. That climatic changes 
and different factors of disease become more or less 
prominent as population increases, forests are de- 
stroyed, and smoke and factory fumes contaminate 
the air, we know. Other conditions are, however, 
believed to occur, such as substances projected into 
our atmosphere from distant worlds and vaporizing 
to such extent as to alter health conditions in large 
degree, giving rise to these otherwise unaccountable 
epidemics. That such occurrences do take place is 
probable, but in the limited state of knowledge 
along such lines there is as yet but little practical 
usefulness in these theories, and for the time being 
they are merely matters of interest, except to a 
few scientists who are willing to devote time, 
money and hard work to the task of increasing 
useful knowledge for the benefit of the world at 
large. 

In conclusion it may be said that exposure to 
cold and dampness has been recognized as a most 
potent exciting cause of respiratory diseases from 
time immemorial. Modern investigation has as- 
signed an equally important role to infection and 
contagion, the growth and multiplication of micro- 
scopical germs known as bacteria, and their trans- 
mission from one individual to another. Among 



44 COLDS, COUGHS AND SORE THROATS. 

other exciting causes we find digestive disturbances, 
mouth breathing, the inhalation of impure air and 
various air-borne substances, and possibly atmos- 
pheric changes of a character as yet not fully under- 
stood. 

A high degree of vitality is the most effective 
safeguard against the exciting causes of disease. 
Exposure to cold and dampness that will surely 
render a weakly, thin-blooded person dangerously 
sick will merely increase a robust, hearty man's 
appetite and make him sleep sounder. Proper 
clothing will enable us to stand a degree of exposure 
that would otherwise be dangerous, and storm- 
proof garments are effective against rain and snow. 

Mouth breathing imperatively demands investiga- 
tion and removal of the cause. Digestive disorders 
should always be remedied, by diet, exercise and 
hygiene as far as possible, by medicines when abso- 
lutely necessary. Plenty of fresh air is every one's 
right and should be secured as far as possible. 

When exposure to exciting causes is unavoidable 
and vitality is not high enough to withstand them, 
measures may sometimes be taken to successfully 
counteract them, as the prompt removal of wet 
clothing, rubbing the skin into a vigorous glow, 
and perhaps taking a stimulant, when chilled and 
wet; washing the mouth and throat and spraying 
the nasal cavities with antiseptic solutions when ex- 
posed to bacterial diseases, and when obliged to 
breathe foul and dust laden air, increased time spent 
in the purest out-of-doors atmosphere available. 



CHAPTER HI. 
Bacteria and Their Relation to Disease. 

Bacteria is the plural form of the word bacte- 
rium, which is derived from a Greek word meaning 
a little stick or short rod. Bacteria are wonderfully 
small plants, differing in many ways from plants 
large enough to be seen by the naked eye and re- 
quiring a powerful microscope to render them visi- 
ble at all, and yet each individual bacterium is a 
distinct and complete organism, leading its own 
separate life and performing its own particular part 
in the economy of Nature just as thoroughly as 
any larger and visible form of plant life, be it tree, 
herb or flower. 

A very common misapprehension as to the true 
character of bacteria arises from the habit of jest- 
ingly referring to them as ''bugs,'' ''little varmints," 
or in other similar terms leading to the inference 
that they are animal organisms. The fact that in 
many varieties each cell leads an independent ex- 
istence, and the further facts that many of them 
have the power of locomotion in high degree, that 
they attack, destroy and consume other cells, and 
in other ways exhibit powers and properties usually 
associated with animal life, adds to this confusion 

45 



46 COLDS^ COUGHS AND SORE THROATS. 

of ideas, and there is no doubt that professional 
men sometimes refer to them as animal organisms 
from forgetfulness as to their true character. 

According to the dictum of modern science, bac- 
teria are vegetable organisms, and this fact should 
not be forgotten, although they are very strange 
and puzzling examples of plant life and differ in 
many ways from the larger flora with which we are 
familiar. 

Bacteria are frequently referred to as microbes, 
micro-organisms or germs. The word "microbe" 
is generally understood to mean a bacterium, but 
it may also be properly applied to a microscopical 
animal organism, as the malarial parasite. The 
word micro-organism simply means a very small 
organism, either animal or vegetable, while the 
word germ is likewise applied indiscriminately to 
bacteria or animal micro-organisms. 

Each bacterium consists of a single cell, so ex- 
ceedingly small that it takes about 5,000 individual 
organisms of the largest forms, and 25,000 or even 
more of the smaller bacteria placed end to end, to 
form a line a single inch in length, while there are 
excellent reasons for believing in the existence of 
forms so minute that the most powerful microscopes 
have as yet failed to reveal them. What they lack 
in size, however, is made up for by their marvelous 
powers of reproduction. Under favorable circum- 
stances a single bacterium within twenty-four hours 



BACTERIA RELATION TO DISEASE. 47 

becomes tens of millions, and each one of these 
millions upon millions continues multiplying at the 
same almost incredible rate, so that in spite of the 
insignificance of the individual bacterium they quick- 
ly become a factor of mighty importance in the 
world's economy. 

Their mode of reproduction is peculiar and gives 
them the name of schizomycetes (splitting or fission 
fungi). Lines of cleavage appear in one, two or 
three planes of the parent bacterium, deepen and 
finally divide the organism into two, four or eight 
portions, each of which rapidly becomes an adult 
cell, when the same process of fission or division is 
repeated, and so on ad infinitum. To explain these 
lines of cleavage in different planes, just suppose 
an apple is cut in half. The path of the knife gives 
one plane of cleavage and the apple is divided into 
two parts. If it is quartered there are two planes 
and four parts; and if it now be cut through mid- 
way between stem and blossom end, there are three 
planes of cleavage and the apple is divided into 
eight parts. Cleavage or fission in bacteria, how- 
ever, gives no such irregular forms as the halves, 
quarters or eighths of the apple. If a string be 
tied around a toy balloon and drawn so tightly as 
to give the appearance of two smaller balloons it 
much more nearly represents bacterial division, but 
in the bacterium the dividing forces act from within 
and growth proceeds while division is going on. 



48 COLDS^ COUGHS AND SORE THROATS. 

SO that the twins, quadruplets or octets may be 
nearly of adult size by the time fission is complete. 
Very probably dividing forces are already active 
in the rapidly growing bacterial offspring, even be- 
fore parental division is complete. 

Another peculiarity of bacterial life, by which 
these minute organisms retain their existence under 
unfavorable circumstances, is spore formation. 
When nutrition fails, or considerable variations of 
temperature are to be met, certain forms of bacteria 
undergo changes of structure resulting in bodies 
known as spores. The spore is believed to be re- 
lated to the bacterium, much as a seed is related to 
the plant that produces it. When this change is 
about to occur, a bright glistening spot appears in 
the substance of the bacterium. This portion be- 
comes constantly larger, while the remainder of the 
bacterium disintegrates and disappears, leaving a 
very resistant, hard and refractive body — the spore. 
This spore can undergo very considerable changes 
of temperature, and survives conditions that would 
infallibly destroy the parent organism. When cir- 
cumstances again become favorable for bacterial 
growth and multiplication, the spore becomes once 
more a bacterium, which immediately takes advan- 
tage of its appropriate environment to divide and 
multiply, exactly as it would have done had no such 
interruption occurred. 

The whole habitable world teems with these tiny 



BACTERIA RELATION TO DISEASE. 49 

organisms. Their numbers are too vast for our 
minds to grasp, but a faint comprehension as to 
their size and numbers, when but a comparatively 
few are dealt with, may be gleaned from the follow- 
ing quotation from William's excellent Manual of 
Bacteriology : *'When one touches a growth of bac- 
teria with the sterilized platinum wire and spreads 
the tiny portion that adheres to the wire upon a 
slip of glass, it is found upon examination with the 
microscope that the bacteria left on the glass may 
be compared to the stars in the sky, the grains of 
sand on the shore, or any of the other standards for 
numbers that are nearly beyond computation/' 

Wherever visible plants and animals exist, bac- 
teria are found in countless millions, in the air, the 
earth and the water, on trees, plants, animals, stones, 
dust and dirt of every description, on the walls of 
our houses, on food, household utensils, clothing, 
window panes, pictures, books, — in short, on or 
in almost everything that you can see, touch or 
think of. They are found in the soil to the depth 
of three or four feet, but lower than this so far as 
present knowledge goes they are absent, and water 
drawn from wells does not usually contain any 
species that present methods reveal. The air on the 
summits of high mountains seems to be bacteria 
free, and the same is true of air examined far out 
at sea. Animals, human beings included, have 
bacteria in their mouths, nasal cavities, bronchial 
tubes, stomachs, intestines, and in all other cavities 



50 COLDS, COUGHS AND SORE THROATS. 

that communicate with the external world, while 
in disease they are also found in the blood and the 
strictly internal organs. Fortunately for the human 
race a very large majority of these hosts of organ- 
isms are harmless, and many of them are actively 
beneficial, while to those varieties that are harmful 
sunlight and cleanliness are deadly enemies. 

Bacteria, properly prepared, stained and examin- 
ed under a powerful microscope, appear as small 
bodies of varying form, round, rod-shaped, comma- 
like, spiral or cork-screw shaped. According to 
these forms and the manner of grouping of the non- 
motile bacteria, they receive various names. The 
round forms are cocci (plural of coccus, a grain 
or berry), and, indicating their microscopical size, 
they are called micrococci. Cocci, occurring in 
pairs, are diplococci (double berries), in fours they 
are tetrads (tetrad, a group of four), and in groups 
of eight they are sarcinse (plural of sarcina, a pack 
or burden). When found in irregular masses they 
are called staphylococci (a bunch of grapes), and 
when in chains, the individual cocci joined end to 
end, they are streptococci (twisted berries or berry- 
wreaths). The rod-shaped organisms, or those 
which are longer in one diameter than another, are 
bacilli (plural of bacillus, a short stafif). Those 
forms that are twisted, each individual appearing 
like several turns of a cork-screw, are spirilla (plural 
of spirillum, a spiral), and the comma-shaped bac- 
teria are considered short forms of the spirilla. 



BACTERIA RELATION TO DISEASE. 5 1 

The bacilli and spirilla are usually motile and rarely 
form characteristic groupings, hence there are no 
group names for these varieties corresponding to 
the diplococci, streptococci, etc., of the spherical 
bacteria. 

Bacteria also differ from visible plants in the fact 
that many, perhaps most, of the rod-shaped and 
spiral forms are actively motile, or possess the power 
of moving freely in liquids or semi-liquid sub- 
stances. Some of them are compared to minnows 
from their swift, darting movements, others resem- 
ble small power boats in their steady, business-like 
progress, and other peculiarities of motion charac- 
terize still other forms. These movements are 
caused by flagella (plural of flagellum, a whip) 
which are whip-like or hair-like processes, capable 
of twisting, turning or lashing movements in such 
manner as to propel the organisms in the fluids 
in which they live or which are prepared for their 
examination under the microscope. Sometimes 
there is a single flagellum at one end, sometimes 
several, or there may be many flagella projecting 
from all parts of the little organism, and frequently 
these processes are many times longer than the bac- 
terium itself. The micrococci, or spherical forms, 
are usually non-motile, hence rarely have flagella, 
and being incapable of any great amount of motion, 
they tend to grow or arrange themselves in some 
regular grouping, as streptococci, staphylococci, etc. 

There are many other facts concerning these as 



52 COLDS, COUGHS AND SORE THROATS. 

yet but slightly understood organisms, and there is 
much that is of the greatest interest in even the 
little that is known of them. Many varieties are 
valuable and necessary in the arts and industries, 
others of vast importance to agriculture, while a 
comparatively small number are capable of produc- 
ing disease. These latter, the pathogenic or disease- 
producing bacteria, are the forms that have been 
most carefully studied, consequently most of our 
knowledge is of these harmful varieties, and this 
fact has given rise to a very false idea of bacteria 
in general. In the minds of very many people the 
idea of bacteria is inseparably connected with dis- 
ease, and largely with the more severe and danger- 
ous forms of disease at that; whereas in truth, but 
a very small proportion of bacteria are responsi- 
ble for disease at all, and a vastly greater number are 
closely connected with the most necessary and bene- 
ficial processes. To understand something of their 
widest field of activity we must devote some time 
to the consideration of the many varieties of bac- 
teria grouped under the heading of saprophytes. 

The word saprophytes literally means rotten 
plants, but a fuller and better rendering would be 
''Microscopical plants, which by their growth cause 
putrefaction and decay.'' All life, including our 
own, is wholly dependent on bacterial life and ac- 
tivity, just as it is on visible plant and animal 
growth. If all visible plant life were destroyed all 
other forms of life would shortly cease, and the 



BACTERIA RELATION TO DISEASE. 53 

same is largely true of animals. These facts are 
generally understood, and it is equally true, thougti 
far from being as well known, that if bacterial life 
were to cease the higher forms would also neces- 
sarily perish. 

Such forms of plant life as are characterized by 
green leaves make use of the waste products of 
animal life for nourishment, and in so doing these 
waste materials are again prepared for animal use. 
Animals breathe in ordinary air and retain the free 
oxygen until combined with other substances in the 
necessary processes of life. In exchange for this 
free oxygen they give off oxygen combined with 
carbon in the form of carbon dioxide, a waste and 
useless substance so far as animals are concerned, 
but the very breath of life to plants, which retain 
the carbon and throw off the oxygen, once more 
fit for animals. 

This process is independent of bacterial action 
and is a simple matter of exchange between plants 
and animals. But other forms of animal waste, 
including their dead bodies, are too complex or too 
highly organized for the use of visible plants and 
these substances must be worked over and reduced 
to simpler forms before further exchange can occur, 
and this is where the friendly bacteria known as 
saprophytes find their great field of usefulness. 
Dead animals, and likewise dead plants, putrefy 
and decay, and very unpleasant they often are until 
the process is carried so far that simpler and in- 



54 COLDS, COUGHS AND SORE THROATS. 

ojffensive substances are formed. But if this un- 
pleasant process did not take place these dead ma- 
terials, plants as well as animal bodies, would simply 
lie unchanged and encumber the earth, and in a 
short time such a large proportion of the more 
necessary elements would be inert and useless that 
life would cease for want of proper material to sup- 
port it. But decay and putrefaction, which are the 
work of swarming myriads of saprophytes (fre- 
quently aided in the first stages by maggots and 
other low forms of animal life), do take place and 
the waste organic matter is reduced to simpler com- 
pounds suitable for the nutriment of visible vegeta- 
tion, which now takes up the process and again 
prepares these matters for animal use as food. Then 
herbivorous animals fulfill their part of Nature's 
scheme, preparing vegetable substances for the sus- 
tenance of flesh-eating animals, and all of these in 
turn fall and furnish more food for bacteria. And 
thus the life cycle rolls on ; plants, animals, bacteria, 
and then visible plants again; a never-ending chain 
with alternating links of animal, vegetable and bac- 
terial life and death, each link of equal importance 
with every other link, and all necessary for the 
continuance of the various forms of life on this 
terrestrial sphere. 

Bacteria which live on and draw their nutriment 
from living plants and animals are called parasites, 
and it is principally among these forms that we 
find the comparatively few pathogenic (disease- 



BACTERIA RELATION TO DISEASE. 55 

producing) varieties. A few notable exceptions 
exist, and of these the deadly bacillus of tetanus 
or lockjaw is most familiar. These bacilli are found 
in garden soil and other earths, and in the excreta 
of certain domestic animals, and here they are of 
course harmless. But when carried deeply into 
living tissues in such manner that the wound closes 
and air is excluded they produce one of the most 
quickly fatal diseases known. 

A punctured wound, such as is often made by 
stepping on a nail or other loose piece of metal, 
affords an ideal location for these dangerous germs, 
and if the piece of metal has lain in contact with 
garden soil, manure, or even the dust of the streets, 
in parts of the country where this bacillus flourish- 
es, lockjaw is very likely to follow. For this reason 
the surgeon converts such a wound into an open 
one by cutting to the very bottom of the puncture 
and so enlarging it that air has access to every part. 
Oxygen is a sure preventive of activity for this 
organism, hence this procedure. As an additional 
precaution, however, the wound is generally steril- 
ized with pure carbolic acid or other powerful germ- 
icide, and in this way all danger is averted. 

Fourth of July wounds, made by prematurely 
exploding fireworks, or by other causes that pro- 
duce jagged, deep and irregular lacerations on sur- 
faces already dirt infected, and very hard to clean, 
are a frequent cause of this disease, and numerous 
cases generally follow any widespread celebration 
that includes fireworks in its list of attractions. 



56 COLDS, COUGHS AND SORE THROATS. 

Where this bacillus is rarely found, as in the high, 
dry plain country of Dakota, vastly worse and 
deeper wounds than such as are ordinarily sufficient 
to produce lockjaw, heal quickly and completely 
with very slight care or none at all. 

The unbroken skin and healthful mucous mem- 
branes are sufficient protection against the milder 
pathogenic bacteria, and even such dangerous varie- 
ties as the bacillus of diphtheria have been found 
in healthy human throats where they may exist for 
months and yet cause no disorder. But that these 
bacilli are still deadly has been proven only too 
well and too often by the transmission of disease 
from these healthy human carriers of the contagion 
to a more susceptible person, with a malignant form, 
of the disease as the result. Numerous deaths from 
contagion thus harmlessly carried by persons, for 
the time being immune, have proven these facts 
beyond question. Moreover, abundant experimental 
proof has surely proven that dogs, cats, and even 
rats and mice can carry the contagion of the most 
deadly ailments, and infectious diseases undoubtedly 
often spread by these means. It is well known that 
the ordinary house fly is a carrier of infection, and 
other insects may at times be equally dangerous. 

A slight congestion of the mucous membranes, 
or the least scratch or break of the external skin, 
afifords even the milder pathogenic bacteria sufficient 
opportunity for harmful activity, and some form 
of disease, or the formation of pus, and sometimes 



BACTERIA RELATION TO DISEASE. 57 

a rapidly spreading septic inflammation, are quite 
possible and by no means infrequent results. Some 
forms of bacteria are always present on the human 
skin and in accidental wounds they are almost cer- 
tain to gain access to the deeper and less resistant 
tissues. Sometimes the vitality of these tissues is so 
high that the bacteria are destroyed or rendered 
harmless and the wound heals healthfully and 
rapidly. In lower conditions of tissue vitality a 
slight inflammation with a small amount of pus 
formation occurs, and in still lower conditions a 
mere scratch may be the starting point of a severe 
and widespread infection with abundant pus forma- 
tion and destruction of tissues. Sometimes when 
the vitality is low these organisms may even gain 
entrance to the deeper tissues along the course of 
a hair follicle or a sweat gland and a boil or car- 
buncle results. 

The elaborately careful sterilization of hands, 
instruments, bandages and other appliances and of 
the parts to be incised in a surgical operation, are 
intended to destroy bacteria which would otherwise 
gain access to the exposed and wounded tissues, 
causing suppuration and all its attendant train of 
ills. It is probable that a small number of bacteria 
do gain access to the field of operation, but health- 
ful tissues can contend with a few germs and no 
harm results. Before the days of surgical asepsis 
and antisepsis, bacteria almost always found abun- 
dant lodgment on the wounded tissues during an 



58 COLDS^ COUGHS AND SORE THROATS. 

Operation, and in those days surgery was often- 
times and with some degree of justice spoken of 
as scientific butchery. At the present time this term 
properly appHes to surgery only when, as sometimes 
happens, needless operations are performed because 
the surgeon ''likes to cut,'' loves to get a good fat 
fee, or craves increase of reputation more than the 
welfare of the patient. 

Those diseases of the respiratory tract of which 
enough is known to speak with any degree of posi- 
tiveness, are all, excepting hay fever, more or less 
dependent on the action of bacteria. Some of them 
are entirely due to these little one-celled plants, 
while in others comparatively mild conditions are 
increased and rendered severe enough to be classed 
as diseases by the same all-pervading germs. It is" 
to bacteria, allied vegetable organisms and certain 
minute forms of animal life, that all infectious or 
contagious diseases owe their power of spreading 
from person to person, and bacteria alone are con- 
sidered responsible for infectious diseases of the 
respiratory tract. Coryza, or the common cold in 
the head, is believed to be complicated and rendered 
more severe by bacteria, although any one or more 
of several varieties may be concerned, and the same 
is true of ordinary pharyngitis and laryngitis. Ton- 
sillitis is believed to be due to some germ, either 
animal or vegetable, diphtheria is known to be 
caused by the Klebs-Loffler bacillus, bronchitis is 
partially due to any one or more of several varieties. 



BACTERIA RELATION TO DISEASE. 59 

lobar pneumonia is due to the pneumococcus, and 
catarrhal pneumonia is a bacterial disease, though 
no one form is necessarily present. The bacillus 
of Pfeiffer causes la grippe, while hay fever is due 
to a vegetable dust, but not a bacterium. 

Some forms of bacteria produce a condition of 
disease by their action on the tissues at their point 
of lodgment, and in addition throw off poisonous 
substances (toxins) which are taken into the cir- 
culation and injuriously affect the whole system. 
Other bacteria produce no symptoms at the point 
of lodgment, but their effects are entirely due to 
the liberated poisons, and of these forms the tetanus 
bacillus is a notable example. The toxins or poi- 
sonous substances are sometimes the result of the 
life processes of the bacteria and depend on the 
living organisms for their formation ; in other cases 
they are contained in the bodies of the germs and 
do not produce injurious results until after the 
death of enough of the organisms to set free suffi- 
cient poisonous matter to cause disease. 

Persons suffering from bacterial diseases throw 
off vast multitudes of the infective germs. In res- 
piratory diseases this is accomplished by sneezing, 
coughing and spitting, and to a much less degree 
in speaking or singing. In quiet breathing the ex- 
pired air is free from germs, and the authorities tell 
us that in a room full of consumptives keeping per- 
fectly quiet but breathing as usual, there would be 
no danger of receiving any of the germs or of 



6o COLDS^ COUGHS AND SORE THROATS. 

contracting the disease. But if some of the lady 
consumptives should commence talking (as they 
surely would) there would be some danger; if they 
should sing there would be greater peril; and if 
they should cough or sneeze the atmosphere of the 
entire room would shortly swarm with the deadly 
tubercle bacillus. 

In other types of disease the intestinal discharges 
are the main sources of infection, and in eruptive 
diseases (those characterized by a rash or other 
breaking out) the infection is contained in the scaly 
particles which are thrown off from the skin and is 
usually contained in other excretory products as 
well. These pathogenic bacteria may also remain 
alive for months on non-living substances, such as 
clothes, bedclothing, handkerchiefs or toys with 
which they have come in contact during the course 
of some case of the disease and after a variable 
period, sometimes as much as, or even much greater 
than a half year, they are still capable of causing 
the disease in its full measure of severity. 

Some knowledge of the requirements and habits 
of bacteria is useful as well as interesting, and 
through such knowledge we obtain reasons for many 
valuable processes known and practiced before any 
of the micro-organisms had been discovered. The 
disease producing bacteria flourish best at or near 
the body temperature and may be destroyed by 
boiling or a high degree of dry heat. Moisture is 
another requirement of bacterial life, while sunshine 



BACTERIA RELATION TO DISEASE. 6l 

kills all of the dangerous forms. This is one of the 
great reasons why sunshine is such an absolute ne- 
cessity and by itself should decide every one to buy, 
rent or occupy only such houses or rooms as have 
an abundance of sun light every day that the sun 
shines and for as many hours of every day as may 
be practicable. Heavy draperies, upholstered fur- 
niture and darkened rooms are regular bacteria 
farms, sheltering and encouraging the deadliest 
forms. The ever-present bacillus of tuberculosis 
finds in such surroundings a congenial dwelling 
place wherein, after the death of one victim, it will 
patiently await another, and the records of what 
are called ''tuberculosis houses" show that it does 
not wait in vain. 

Houses built side by side so that only front and 
rear have light, air and sunshine are a direct viola- 
tion of one of Nature's plainest laws and ought to be 
forbidden by law in the interest of public health. 
Churches, theaters and other buildings which are 
at times crowded with human beings, should be 
solidly and plainly constructed, cushioning and 
draperies avoided, and should be ventilated thor- 
oughly and scientifically. Railroad cars, street cars 
and other closed conveyances are always a possible 
source of contagion, and this fact should be taken 
into consideration in their use. 

As a mere matter of fairness and justice, if you 
must sneeze or cough in a crowded hall, a closed 
conveyance or other public place, hold your hand- 



62 COLDS, COUGHS AND SORE THROATS. 

kerchief before your face, and if some ill-bred or 
grossly ignorant person sneezes or coughs toward 
you without using such precaution, turn your own 
face away or intervene your own handkerchief so 
that at least you need not breathe in the expelled 
germs. 

The free use of warm water and good soap is 
another measure very destructive to pathogenic bac- 
teria and is at all times applicable to hands, cloth- 
ing, utensils and bedding. If there is known ex- 
posure of clothing, towels, handkerchiefs or bed- 
ding to the germs of disease, boiling the infected 
articles is a certain and speedy way of destroying 
the microbes. Free and prolonged use of warm 
water and good soap is the first step in sterilizing 
the hands in preparing for surgical operations, and 
in purifying them if infected, and many physicians 
believe it to be the most important part of the whole 
proceeding. 

Should any of the readers of this book desire 
further knowledge on this most interesting subject, 
it will pay to invest a dollar or two in some good 
book on bacteria, and in this particular instance 
one of the smaller technical works designed for the 
use of medical men and students will probably serve 
the purpose better than those books which spoil the 
subject by trying to make it so plain that a five-year- 
old child can understand what little is really told, and 
leaving out the most interesting and practical parts 
for fear of over-taxing the reader's comprehension. 



CHAPTER IV. 

Infectious and Contagious Diseases and 
Their Causes. 

This chapter might with almost perfect propriety 
appear under the heading of ''Alicro-organisms and 
Their Results/' for all infectious and contagious 
diseases are caused by living organisms of micro- 
scopical size. What difference whether we say, 
''Diphtheria and its cause/' or ''The Klebs-Loffler 
bacillus and its results'' ? 

An infectious disease is one caused by some form 
of living micro-organism, either vegetable or ani- 
mal, which by its growth and multiplication in 
or on the body of the victim, causes the disease 
in question. If these disease-producing organisms 
can be transferred directly from one human being 
to another, the disease which they cause is directly 
contagious, while those in which the infection can 
not be transferred directly, but requires some inter- 
mediate agency (as the mosquito in malaria and 
yellow fever), are indirectly contagious. Ordinari- 
ly the two words, infectious and contagious, are 
used interchangeably. 

All of the respiratory diseases considered in this 
book, with the single exception of hay fever, are 
believed to be infectious and directly contagious, 
and all of them in which the inefective organism has 

63 



64 COLDS, COUGHS AND SORE THROATS. 

been certainly determined, are due to bacteria, or 
vegetable micro-organisms. 

After the bacteria effect a lodgment in the mouth, 
or some part of the respiratory passages, a certain 
amount of time, known as the incubation period, 
elapses before the germs manifest their activity. 
In some instances this interval is very short, perhaps 
a day or two, in other cases it may be several weeks. 
During the incubation period there may be no indi- 
cations that the victim has contracted disease, but 
more commonly there are mild symptoms of ill 
health which are known as prodromes, or prodro- 
mal symptoms. At the expiration of the incubation 
period the disease breaks out, frequently with vio- 
lence and great suddenness, and from this time on 
to recovery or death it follows a recognized course. 
Why the symptoms are so slight and indefinite for 
a certain period of time, and then break out, in 
many instances with almost explosive violence, has 
not, as yet, been satisfactorily explained. That it 
is so, however, is proven by a vast amount of ex- 
perience. 

The pathogenic organisms cause disease by vari- 
ous methods. Sometimes their growth gives rise 
to inflammation and tissue destruction at the point 
of lodgment. Frequently in their growth and mul- 
tiplication they manufacture deadly poisons (tox- 
ins), which are carried to all parts of the body in 
the blood and lymph currents, affecting the whole 



INFECTIOUS AND CONTAGIOUS DISEASES. 65 

system, and causing general, or constitutional symp- 
toms. And quite commonly one and the same or- 
ganism will produce both the localized inflammation 
and injury, and the general poisoning by violent 
toxins. In diphtheria we have a fine illustration 
of this combination of ill results. The bacilli cause 
inflammation and coagulation of tissues at their 
point of lodgment, while at the same time the most 
violent poisons are thrown into the circulation and 
carried to all parts of the body. 

While knowledge concerning disease-producing 
germs is still in its infancy, an amount of informa- 
tion has already been obtained that is of the greatest 
practical value. It explains facts and methods 
known and practiced for ages, and renders their 
application more rational and satisfactory. That 
rooms exposed to the direct rays of the sun are 
vastly more conducive to health than those remain- 
ing in shadow and comparative darkness, has been 
recognized from the days of the cave-dwellers. 
That sunshine is one of the most fatal influences 
to which the tubercule bacillus and other deadly 
germs can be exposed, explains a part of the value 
of sunlight and renders its admission into dwelling 
rooms more imperative. Cleanliness is justified on 
more positive grounds than mere increase of com- 
fort and improved appearance. Cooking becomes of 
vast importance when the influence of heat on dis- 
ease germs is understood, and sanitation becomes 
a necessity, justified by exact knowledge. Isolation 



66 COLDS, COUGHS AND SORE THROATS. 

of persons suffering with contagious diseases, prac- 
ticed in the dark ages, and by savage people, by 
abandoning the victims, is reduced to a rational 
procedure benefiting both patient and relatives. 

Infectious and contagious diseases are to be 
avoided, or combated, by maintaining high vitality, 
by sanitary surroundings and strict cleanliness, by 
isolation of the sick and their attendants, and by the 
use of various germicides and modes of disinfec- 
tion. 

Even in those respiratory diseases which are only 
mildly contagious, such as coryza and pneumonia, 
a moderate amount of precaution is profitable. 
Coughed-up matter or other discharges from mouth 
or nose should be disinfected or burnt, and the hands 
should at least be well washed in warm water and 
soapsuds after coming in contact with any such sub- 
stances. Ventilation and abundant sunlight should 
be secured, both for their healthful influence on the 
human beings concerned, and for their destructive 
action on contagion. Handkerchiefs, even in a mild 
case of coryza, should not be long used, nor allowed 
to become much soiled. In pneumonia, owing to 
its dangerous character, especial care should be ta- 
ken to destroy or disinfect any source of contagion, 
and as few people should be about the patient as 
possible. In the more actively contagious diseases, 
as diphtheria, whooping cough and la grippe, much 
greater precautions should be observed. In diph- 
theria especially, the patient and his nurse should 



INFECTIOUS AND CONTAGIOUS DISEASES. 67 

have a room to themselves in which no other person 
save the physician in charge should be allowed. If 
two rooms can be given up to them, and one room 
disinfected while the other is in use, it is distinctly 
advantageous. Nothing should leave such a room 
without thorough disinfection, and in every way the 
contagion must be prevented from spreading. For 
the patient himself, of course, antitoxin is the great- 
est prophylactic measure attainable. 

The following rules of the New York Board of 
Health, taken from Jacobi's ''Therapeutics of In- 
fancy and Childhood,'' edition of 1893, will give 
most valuable instruction as to the management 
of contagious diseases : 

PREVENTION OF CONTAGIOUS DISEASES. 

Directions of the New York Health Department, 



Diphtheria, Scarlet Fever, Measles. 

"These diseases are very contagious. Diphtheria 
is usually transmitted from the sick to the well by 
the moist or dry discharges from the nose and 
throat of the sick person. Scarlet fever and measles 
are transmitted by the discharges from the nose and 
throat and also by the scales thrown off from the 
surface of the skin. These discharges and scales 



68 COLDS, COUGHS AND SORE THROATS. 

contain the minute germs that cause these diseases. 
The importance, therefore, of their proper disin- 
fection can be at once understood. 

Directions to Prevent Other Cases of Diph- 
theria, Scarlet Fever, and Measles Occur- 
ring IN A Family Where One Case Exists. 

''i. If possible, one attendant should take the 
entire care of the sick person, and no one else be- 
sides the physician should be allowed to enter the 
sick room. The attendant should have no com- 
munication with the rest of the family. The mem- 
bers of the family should not receive or make visits 
during the illness. 

"2. The discharges from the nose and mouth 
must be received on handkerchiefs or cloths, which 
should be at once immersed in a carbolic solution 
(made by dissolving six ounces of pure carbolic acid 
in one gallon of hot water, which may be diluted 
with an equal quantity of water). All handker- 
chiefs, cloths, towels, napkins, bed-linen, personal 
clothing, night clothes, etc., that have come in con- 
tact in any way with the sick person, after use 
should be immediately immersed without removal 
from the room in the above solution. These should 
be soaked for two or three hours and then boiled 
in water or soapsuds for one hour. 

"3. In diphtheria and scarlet fever great care 
should be taken, in making applications to the 



INFECTIOUS AND CONTAGIOUS DISEASES. 69 

throat or nose, that the discharges from them in 
the act of coughing are not thrown into the face 
or on the clothing of the person making the appHca- 
tion, as in this way the disease is Hkely to be caught. 

''4. The hands of the attendant should always 
be thoroughly disinfected by washing in the car- 
bolic solution, and then in soapsuds, after making 
applications to the throat or nose, and before eating. 

'^5. Surfaces of any kind soiled by the discharges 
should be immediately flooded with the carbolic 
solution. 

''6. Plates, cups, glasses, knives, forks, spoons, 
etc., used by the sick person for eating and drinking 
must be kept for his especial use, and under no 
circumstances removed from the room or mixed 
with similar utensils used by others, but must be 
washed in the room in the carbolic solution and then 
in hot soapsuds. After use the soapsuds should be 
thrown in the water closet, and the vessel which 
contained it should be washed in the carbolic solu- 
tion. 

'^7. The room occupied by the sick person should 
be thoroughly aired several times daily, and swept 
frequently, after scattering wet newspapers, saw- 
dust, or tea leaves on the floor to prevent the dust 
from rising. After sweeping, the dust upon the 
woodwork and furniture should be removed with 
damp cloths. The sweepings should be burned and 
the cloths soaked in the carbolic solution. In cold 
weather, the sick person should be protected from 



70 COLDS^ COUGHS AND SORE THROATS. 

draughts of air by a sheet or blanket thrown over 
his head while the room is being aired. 

''8. When the contagious nature of the disease 
is recognized within a short time after the beginning 
of the illness, after the approval of the Health De- 
partment Inspector, it is advised that all articles of 
furniture not necessary for immediate use in the 
care of the sick person, especially upholstered furni- 
ture, carpets, and curtains, should be removed from 
the sick room. 

"9. In scarlet fever and measles, when the pa- 
tient is beginning to recover and the skin is peeling 
off, the body should be washed once daily in warm 
soapsuds, and afterwards annointed with oil or vas- 
eline. This should be continued until all roughness 
of the skin has disappeared. 

*^io. When the patient has recovered from any 
one of these diseases, the entire body should be 
bathed and the hair washed with hot soapsuds, and 
the patient should be dressed in clean clothes (which 
have not been in the room during the sickness) 
and removed from the room. Then the Health 
Department should be immediately notified, and 
disinfectors will be sent to disinfect the room, bed- 
ding, clothing, etc., and under no conditions should 
it be again entered or occupied until it has been 
thoroughly disinfected. Nothing used in the room 
during the sickness should be removed until this 
has been done. 

"11. The attendant and any one who has as- 



INFECTIOUS AND CONTAGIOUS DISEASES. 7 1 

sisted in caring for the sick person should also take 
a bath, wash the hair, and put on clean clothes, be- 
fore mingling with the family or other people, 
after the recovery of the patient. The clothes worn 
in the sick room should be left there to be disin- 
fected with the room and its contents by the Health 
Department. 

Methods of Disinfection. 

"i. Hands and Person. Standard Solution No. 
I * should be diluted with an equal amount of 
water. Hands soiled in caring for persons suffering 
from contagious diseases, or soiled portions of the 
patient's person, should be immediately and thor- 
oughly washed in this solution, and then washed 
with soap and water. The nails should be kept 
perfectly clean and the hands should always be care- 
fully disinfected before eating. 

''2. Soiled Clothing, Towels, Napkins, Beddings 
etc., should be immediately immersed in Standard 
Solution No. i, and soaked for twelve hours, being 
occasionally moved about in the fluid so as to bring 
the disinfectant in contact with all parts. They 
should then be wrung out and boiled in soapsuds 
for one hour. Articles, such as beds, etc., that can 
not be washed should be burned. 

"3. Food and Drink. Food thoroughly cooked 
and drinks that have been boiled are free from dis- 

*See " Carbolic Acid" in list of disinfectants, page 74. 



y2 COLDS^ COUGHS AND SORE THROATS. 

ease germs. In presence of an epidemic of cholera 
or typhoid fever, milk and the water used for drink- 
ing, cooking, washing dishes, etc., should be boiled 
just before using, and all persons should avoid eat- 
ing fruit, fresh vegetables, and ice. Ice may, how- 
ever, be used when ordered for the sick by a physi- 
cian. 

'*4. Discharges of all kinds from patients suffer- 
ing from contagious diseases should be received 
into earthen vessels containing Standard Solution 
No. I or 3. Special care should be observed to dis- 
infect at once the vomited matter and the intestinal 
discharges from cholera patients, as these alone 
contain the dangerous germs. The volume of the 
disinfecting solution used should be at least four 
times as great as that of the discharge. After 
standing for at least one hour in the disinfecting 
solution, these discharges may be thrown into the 
water closet. Bedding or clothing soiled by the 
discharges must be at once placed in Solution No. 
I, and the hands of the attendants disinfected, as 
described above. 

"5. Closets, Sinks, etc. Each time the closet is 
used for infected material, at least one quart of 
Solution No. i should be poured into the emptied 
pan and allowed to remain there. All discharges 
should be disinfected before being thrown into the 
closet. Sinks should be flushed at least once daily 
with the same solution. 

"6. Dishes, Spoons, etc., used by the patient 



INFECTIOUS AND CONTAGIOUS DISEASES. 73 

should be kept for his exclusive use, should not be 
removed from the room, but should be washed there, 
first in Solution No. i, and then boiled in strong 
soapsuds. These washing fluids should afterwards 
be thrown into the water closet. The remains of 
meals should be thrown into a vessel containing 
milk of lime. The contents of the vessel, after 
standing half an hour or more, should be thrown 
into the water closet. 

''7. Soiled Wood-work, Floors, Plain Furniture, 
etc., should be thoroughly washed with Solution 
No. 2. Upholstered furniture, curtains, or carpets 
which have been soiled by the discharges should be 
referred to the Health Department for disinfection 
or destruction. 

'Tt is important to remember that an abundance 
of fresh air, sunlight, and absolute cleanliness not 
only help protect the attendant from infection, but 
also aid in the recovery of the sick. 

'*Note. — The cost of the carbolic solution is much 
greater than that of the other solutions, but gene- 
rally it is to be much preferred. When the cost is 
an important element, the bichloride solution may 
be substituted for all purposes for which the car- 
bolic is recommended, excepting for the disinfec- 
tion of discharges, eating utensils, or articles made 
of metal, and of clothing, bedding, etc., which is 
very much soiled. Its poisonous character, except 
for external use, must be kept constantly in mind. 



74 colds, coughs and sore throats. 

Disinfection and Disinfectants. 

"The contagious diseases are caused by minute 
living germs. The object of disinfection is to de- 
stroy these. In order that as few articles as possi- 
ble shall be exposed to infection by the disease 
germs, at the very beginning of the illness all un- 
necessary furniture (especially upholstered furniture 
and curtains) and other unnecessary articles, should 
be removed from the sick room. 

''The following are the best known disinfectants : 

''i. Heat. Continued high temperatures destroy 
all forms of life. Boiling for at least one-half hour 
will destroy all disease germs. 

''2. Carbolic Acid. Standard Solution No. i is 
composed of six ounces of carbolic acid, dissolved 
in one gallon of hot water. This makes approxi- 
mately a five-per-cent. solution of carbolic acid. 
The commercial colored impure carbolic acid will 
not answer for this purpose. Great care must be 
taken that the pure acid does not come in contact 
with the skin. When practicable, the carbolic solu- 
tion should be used as hot as possible. 

''3. Corrosive Sublimate (bichloride of mer- 
cury). Standard Solution No. 2 is composed of 
sixty grains pulverized corrosive sublimate and 
sixty grains of chloride of ammonia, dissolved in 
one gallon of water. This solution must be kept 
in glass, earthen or wooden vessels (not in metal 
vessels). 



INFECTIOUS AND CONTAGIOUS DISEASES. 75 

''The above solutions are very poisonous when 
taken by mouth, but are harmless when used ex^ 
ternally. 

''4. Milk of Lime. Standard Solution No. 3 is 
made by mixing one quart of dry, freshly slaked 
lime with five quarts of water. Lime is slaked by 
pouring a small quantity of water on a lump of 
quick-lime. The lime becomes hot, crumbles, and 
as the slaking is completed, a white, dry powder 
results. The powder is used to make Solution No. 
3. Air-slaked lime has no value as a disinfectant. 

"The proprietary disinfectants, often widely ad- 
vertised, and whose composition is kept secret, are 
relatively expensive and often unreliable and in- 
efficient. It is important to remember that sub- 
stances which destroy bad odors are not necessarily 
disinfectants." 

While some of the above precautions may not be 
applicable to respiratory diseases, and others (as 
notice to the Board of Health) do not apply to 
country districts, enough is given that is applicable 
to town and city, home and hospital treatment, to 
furnish a good working basis and explain what ob- 
jects are aimed at and how contagion can be re- 
stricted. 

In any community or in any home where it is 
determined to prevent the spread of infection, it can 
be done, and as a rule it will be done. Its impor- 
tance is apparent to every one, and every one should 
assist in limiting the dangerous contagious diseases 
to the smallest number of victims possible. 



CHAPTER V. 

Apparatus Used in Treatment of Respiratory 
Diseases. 

Discomfort and restlessness consume large 
amounts of vital energy; therefore, whatever adds 
to the patient's physical comfort exerts a beneficial 
influence on the course of his disease. For this 
reason certain very simple articles of apparatus for 
the sick room are highly useful, and many such 
can be supplied, with little or no expense, in every 
home. A small outlay of money will provide other 
articles that will pay for themselves ten times over 
in comfort and in the increased chances of a quick 
and favorable recovery from disease. 

The articles described in this chapter are useful 
in the treatment of respiratory diseases, but their 
application is not by any means limited to diseases 
of that character. In fact, many of them are useful 
in almost any condition of disease, and should form 
a part of the household furnishing in every home. 
If any of our readers wonder at descriptions being 
given of articles as familiar to them as the letters 
of the alphabet, they must kindly remember that 
it is hoped that this book will be read in houses 
where an atomizer is as great a novelty as an air 
ship and a soft-rubber hot water bottle is only 

76 



APPARATUS USED IN TREATMENT. "JJ 

known of by hearsay. Also many other articles 
might have been herein included, and perhaps very 
properly. The aim has been to mention only some 
of the simplest and most readily obtainable. 

Among these simple aids to comfort, extra pil- 
lows may be mentioned, by means of which a rest- 
less or convalescing patient may change his attitude, 
and light cushions to go under the hollow of the 
back, or give grateful change to tired or painful 
limbs. Regular back rests are procurable, but they 
are less convenient than the pillows and do not 
permit of as many uses. 

One or more small tables or stands, that may be 
moved about as desired, set close to the bed for the 
invalid's use, or for the basin when giving him a 
bath ; that may be used for food and dishes at meal 
times, and at other times, for flowers, books, etc., 
are simple and very convenient appliances. They 
should be strong and light and, in contagious dis- 
eases, of such character as to permit of ready sterili- 
zation. 

In diseases marked by great loss of strength, so 
that the patient may not even leave the bed to at- 
tend to the calls of nature, bed pans and urinals 
must be supplied to meet the emergency. They are 
of small cost and may be found at most of the 
hardware and house furnishing stores. Drug stores 
also commonly carry them in stock. Light metal 
articles are probably the best as being most readily 



78 COLDS, COUGHS AND SORE THROATS. 

cleansed and sterilized, but very good ones may be 
had in earthenware or glass. Chamber vessels must 
also be provided, of similar light and easily disin- 
fected material. In respiratory diseases a spit-cup 
is also often needed. Often some household utensil 
will answer this purpose, but ease of cleansing must 
always be borne in mind. Wash bowls, water 
pitchers, and slop pails are also needed, and all 
should be light and readily sterilizable. A portable 
bathtub is an inexpensive luxury, and will permit 
the convalescing patient to enjoy a full bath in a 
warm room. So simple a matter as an abundance 
of safety pins will also be found of great conveni- 
ence. 

An ordinary thermometer is useful, and will often 
show that the part of the room occupied by the 
patient is really chilly, while to the nurse, or other 
attendant, sitting nearer the fire, it seems properly 
warm. The clinical thermometer, used for taking 
the patient's temperature, is often of service. It 
is a closed glass tube, one end of which forms 
the mercury bulb. Figures at the side enable the 
temperature to be ascertained. The bulb, or end 
containing the mercury, is slipped as far under the 
patient's tongue as the size of his mouth will allow, 
the lips (but not the teeth) are tightly closed and 
the thermometer allowed to remain for from two 
to five minutes. Or it may be placed in the arm- 
pit with the arm held closely to the side, but re- 



APPARATUS USED IN TREATMENT. 79 

quires longer in this position to secure an accurate 
reading. As the column of mercury is very small 
a magnifying index thermometer should always be 
used. It requires some practice to read the tem- 
perature correctly, the thermometer being turned 
slowly in the fingers until the mercury shows plain- 
ly. After using, the mercury must be shaken down, 
and many thermometers are broken in this process. 
The tube should be taken in the thumb and fingers 
of the right hand as a penholder is held. A quick, 
sharp fling of the hand is required to bring the 
mercury down, and the thermometer must be tight- 
ly held, or another one purchased. The tempera- 
ture should not be taken too often. Once in two 
or three hours is enough, even in severe illness, 
and twice a day is usually sufficient. More than 
this worries the patient needlessly and does no good. 
The soft-rubber hot water bottle is useful in many 
ways and should find a place in every household. 
A very efficient substitute is found in an ordinary 
glass bottle of large size, which can be securely 
corked after receiving the hot water. Other sub- 
stitutes are large, smooth stones, bricks and even 
blocks of hard wood. Care must be taken with all 
of these appliances, to avoid too great a degree of 
heat, and they should be wrapped in large towels, 
blankets, or other cloths, before being used. Prop- 
erly wrapped they retain their heat for a surprising 
length of time. A large stone, well heated and 



8o COLDS^ COUGHS AND SORE THROATS. 

well wrapped, will retain heat for many hours in 
a zero temperature. Any of these appliances placed 
at the feet of a chilly patient will add greatly to 
his comfort and keep him snug and warm all night. 
In cases of collapse, or great weakness, where the 
patient grows cold and the circulation flags, a num- 
ber of these hot water bottles should be placed 
about him. They will impart the necessary heat 
and frequently, in conjunction with internal stimu- 
lants, save life. It is claimed that when bed cloth- 
ing is scanty, a good hot water bottle will equal 
two blankets as a means of keeping warm. Often 
an agonizing stitch in the side, or other localized 
pain, will yield as if by magic to a hot water bottle 
laid over the affected area. The rubber bag, form- 
ing the main part of a fountain syringe, can be 
readily transformed into a hot water bottle. 

Ice bags, also made of soft rubber, are of various 
shapes and sizes, adapted to different parts of the 
body. A broad, flat form is used for chest and 
abdomen. The bladder of a sheep or pig may be 
used as a substitute. These appliances are partly 
filled with small pieces of ice, tightly tied, wrapped 
in towels and applied to the proper part. They are 
often used over the painful area in pneumonia or 
pleurisy, and smaller forms are applied to the side 
of the neck or about the throat in tonsillitis and 
other forms of sore throat. These ice bags should 
always be wrapped in some kind of cloth, to prevent 



APPARATUS USED IN TREATMENT. 8 1 

too great a degree of cold, and to keep moisture 
from gathering on the cold surface. If the patient 
feels at all uncomfortable under these cold appli- 
cations they should, as a rule, be promptly dis- 
continued. 

Compresses are a convenient and efficient method 
of applying either heat or cold. They are easily 
improvised from large towels, folded to suitable 
size and thickness and wrung out of very hot or 
very cold water, and frequently changed, so as to 
keep the temperature at about the right point. Hot 
compresses retain the heat much longer if covered 
with oiled silk, rubber cloth, or other protective 
that checks heat dissipation. A cold compress, 
frequently changed, often gives most marked relief 
in headache, and in various inflammations it will 
prove most useful. 

A coal oil heater is sometimes very handy in sick- 
ness, either for warming the room, furnishing heat, 
heating water, or preparing food. Its odor, and 
the impurities due to its combustion, are to be taken 
note of, and greater quantities of fresh air must 
be admitted to the room when it is employed. An 
alcohol lamp will boil sufficient water to keep the 
air of the room moist, or to prepare a good many 
articles of diet, and it contaminates the air very 
slightly as compared with the coal oil heater. Gas 
heaters, or cooking devices, are open to the same 
objections as the coal oil stove, and are to be used 



82 COLDS, COUGHS AND SORE THROATS. 

with the same precautions. If a stove is used for 
warming the sick room a kettle should always be 
kept on its top to moisten the air properly. In 
furnace-heated rooms the air is almost always dry 
and harsh. This may be remedied by having a pan 
of water so placed that the incoming hot air must 
pass over the water. 

The croup kettle is used to keep the air of the 
sick room moist, and if desired, medicated. For 
description see Chapter XI, ^'Bronchitis." A tea- 
kettle may be used as a substitute for the croup 
kettle and the results are exactly similar. A piece 
of rubber tubing of proper size to fit the spout will 
serve the same purpose as the extra tubing used 
for lengthening the spout of the croup kettle. 
Coffee-pots and other household utensils have been 
employed for the same purpose with very satisfac- 
tory results. 

The bronchitis tent is simply a tent built over the 
bed of the invalid, with one side partially open to 
insure sufficient ventilation. Its object is to keep 
the steam-moistened air furnished by the croup 
kettle close about the patient, and it also serves to 
prevent drafts. A fuller description of this appli- 
ance is given in Chapter XI, ''Bronchitis.'' 

The benefits of both croup kettle and bronchitis 
tent have frequently been obtained by substitutes 
of various kinds, and generally with very satisfac- 
tory results. One resourceful mother, whose little 



APPARATUS USED IN TREATMENT. 83 

girl was seized with a very sudden and alarming 
attack of croup, devised an emergency tent and 
kettle that deserve mention. Hastily filling a pitcher 
with boiling water, and calling to her husband to 
bring the requisite medicine, she clasped the child 
in her arms, seated herself in a low chair and drew 
a sheet over herself, the child and the steaming 
pitcher. Together they inhaled the medicated 
steam, and both are still very much alive. A 
pitcher of boiling water set on an improvised shelf 
in the bronchitis tent, or on a stand drawn within 
its limits will, if frequently renewed, furnish an 
abundance of steam for a mild case, and allows the 
use of any suitable drugs. 

Inhalation of steam, medicated or not, is easily 
secured for brief periods by filling a pitcher two- 
thirds full of boiling water, adding any required 
drug, holding the face over the pitcher, and covering 
both head and pitcher with a towel. Care must be 
taken that the patient, especially if a child, is not 
scalded. A paper cone may be held over the pitcher 
and the vapor thus directed to the mouth and nose 
of the patient. By this mode there is no danger of 
suffering from the heat. After using any of these 
steam inhalations, exposure to cold must be abso- 
lutely avoided, or the last state of that patient may 
be vastly worse than the first. 

By keeping the croup kettle briskly boiling, the 
air of the whole room is easily filled with steamy 



84 COLDS, COUGHS AND SORE THROATS. 

vapor. Large lumps of unslaked lime, dropped in 
a pail or tub of water, will give a vapor that is 
considered very beneficial in case of croup. 

Pocket inhalers and menthol cones are familiar 
to every one. They may be obtained at any drug 
store, and fulfil a useful mission in averting or 
modifying mild colds. If a glass tube can be se- 
cured two or three inches in length and of such 
diameter that the ends may be closed with small 
corks, a very good pocket inhaler can be made at 
home. A few grains of menthol, a larger quantity 
of ammonium chloride or a few crystals of cam- 
phor, may be placed in the middle of the tube. A 
small, loose plug of absorbent cotton, or other light, 
porous substance, is pushed into each end and the 
corks fitted to the ends. To use, withdraw both 
corks, place one end of the tube in the nostrils, 
hold the other nostril with finger or thumb, and 
inhale deeply. Repeat the process with the other 
nostril, and replace the corks tightly when through. 

Atomizers, nebulizers and vaporizers are forms 
of apparatus designed to throw fluids, watery or 
oily, medicated or otherwise, into the nasal and 
other respiratory passages. The ordinary hand at- 
omizer consists of a rubber bulb which acts as an 
air forcing pump, a reservoir for the fluid, and 
the necessary tubing, tips, etc., to connect the parts 
and fit it for its work. A small tube, usually of 
glass or hard rubber, extends from near the bottom 



APPARATUS USED IN TREATMENT. 85 

of the reservoir through its cap or stopper, where 
it meets a similar tube from the rubber bulb. Some- 
times the two tubes run side by side, at other times 
the tube for fluid is contained in the other. The 
arrangement is such that the air under pressure 
passes in front of the opening of the tube from the 
fluid reservoir. This causes a vacuum which draws 
the fluid from the reservoir into the air current, 
where it is finely divided and carried forward in 
the form of a spray. Compressing the rubber bulb 
in the hand starts the atomizer to working, and 
the spray may be directed to any part of the upper 
air passages. 

In the oil atomizers and nebulizers, air is forced 
into the reservoir and throws a portion of the liquid 
against the sides thereof. This forms a vapory 
cloud, which is made still finer by being taken up 
in the outgoing current of air so that it gives the 
appearance of a fine mist or a small cloud. Steam 
vaporizers are pretty little instruments and do their 
work well. They are more complicated than the 
others and perhaps less desirable on this account. 
Some form of vaporizer or nebulizer should be used 
when it is desired to reach the deeper parts of the 
respiratory passages, and deep breaths should also 
be taken when they are used, so as to draw the misty 
vapor deeply inwards. 

Cotton swabs, or applicators, are made by wrap- 
ping a small piece of cotton firmly on the end of 



86 COLDS, COUGHS AND SORE THROATS. 

a slender stick, or a light metal rod especially made 
for the purpose. A match stick, with the phos- 
phorus removed, will answer for applications to 
the interior parts of the nasal passages. A small 
piece of cotton (absorbent cotton should be used) 
is pulled into a thin sheet, a half inch or less in 
width and about an inch in length. The end of 
the applicator is laid on the cotton close to one 
edge, and in such position that about half the sheet 
of cotton will extend beyond the applicator. The 
cotton is now wound or rolled very closely on to 
the applicator and gives a soft, cottony swab, which 
can be used about the delicate membranes of the 
mouth, nose or throat without any danger of injury. 

Medicine droppers are probably familiar to every 
one. They are used perhaps as extensively for fill^ 
ing fountain pens as for dropping medicines, and 
can be secured for a few cents apiece at any drug 
store. They are very convenient in securing proper 
dilution of small quantities of any kind of fluid, one 
dropper full of the required fluid being added to 
as many dropperfuls of water as is required in the 
dilution. 

Douche instruments are receptacles of such ar- 
rangements that a stream of water, or other liquid, 
may be directed against any part of the body, or 
into any of the body cavities. The smaller ones 
hold a half ounce or less, while the fountain syringe 
holds several quarts. The Birmingham pattern af- 



APPARATUS USED IN TREATMENT. 8/ 

fords very handy douches for nose use. They are 
much Hke small vials with the neck drawn out al- 
most to a point, and a larger opening in the side 
to admit liquids. When in use, a finger held over 
the side opening regulates the flow, and any desired 
amount of the liquid can be allowed to escape. 
The Thudicum douche is practically a flat-bottomed 
bottle, with an opening near the bottom connecting 
with a rubber tube which carries a tip suitable for 
use in irrigating nose, throat, or other parts. The 
siphon douche needs only a rubber tube carrying 
a suitable tip at one end. The tube is filled with the 
liquid to be used, the open end is dropped in any 
kind of vessel containing the fluid and the tip low- 
ered. Siphonage of course occurs and the douche 
instrument works perfectly. Of all the douche in- 
struments, however, the familiar fountain syringe 
is probably the most convenient and efficient and 
is to be recommended for any purpose requiring 
more than two or three ounces of liquid. 

Numberless other appliances might be mentioned, 
many of them as useful as those herein referred 
to. The aim has been to mention a few of the more 
prominent and more generally useful. Different 
cases call for different apparatus and whatever will 
aid in giving the patient comfort and relief should 
be supplied if possible. 



CHAPTER VL 
Medicinal Remedies and Their Doses. 

The object of this chapter is to give a few gene- 
ral directions as to dosage and the methods of ad- 
ministering medicines, and to speak of certain valu- 
able remedies a little more fully than can be done 
in the body of the work. 

The directions for taking any liquid medicine 
usually specify that so many drops, or a teaspoon- 
ful, a desert-spoonful, or one or more tablespoon- 
fuls, are to be taken at certain intervals. 

The little medicine droppers, found in all drug 
stores, afford the most convenient method of meas- 
uring by drops. A drop is supposed to equal one 
minim of the Apothecary's fluid measure. In the 
case of water this is about correct, but denser 
liquids, such as syrups, may give drops of double 
this size, while tinctures and other lighter fluids 
often yield two or more drops to the minim. The 
form and size of the containing vessel also influence 
the size of a drop. For these reasons none of the 
very powerful and dangerous remedies are given 
by drops. 

A teaspoonful is supposed to equal a fluid drachm, 
which is one-eighth of a fluid ounce. The ordinary 
teaspoon really contains a little more than a fluid 

88 



MEDICINAL REMEDIES AND THEIR DOSES. 89 

drachm. Two teaspoonfuls equal one desert-spoon- 
ful and four teaspoonfuls, or two desert-spoonfuls 
equal one tablespoonful. The tablespoonful is sup- 
posed to equal half a fluid ounce. It really contains 
a little over this amount. 

In a few instances, medicines that occur in solid 
form (crystals or powders) are directed to be taken 
in spoonful doses. Epsom salts furnishes a familiar 
example. Usually such medicines are directed to 
be taken in doses of so many grains, or so many 
fractions of a grain. At the present day, exact 
doses of most of the solid medicines are easily se- 
cured by the use of pills, tablets, tablet triturates 
or lozenges. Of these various forms, the tablet 
triturates are perhaps most desirable. A tablet can 
be secured of almost any desired size, and by using 
two or more for larger doses and dividing a tablet 
into any required number of parts for smaller doses, 
all ages can be properly suited. Whether pill, tablet 
or lozenge be used, it should be one prepared by 
some well established and reliable firm, and be rea- 
sonably fresh at the time of purchase. A dust- 
covered package, or a bottle with stained label and 
partially decayed cork, is a poor recommendation 
for the efficacy of the contained drug. 

All medicines should be kept in carefully closed 
and accurately labeled containers, in a dark and 
moderately cool place, and preferably under lock 
and key. If children, or other irresponsible per- 
sons, have access to pow^erful drugs, accidents may 



90 COLDS^ COUGHS AND SORE THROATS. 

be expected as a matter of course. One reliable 
person should have full charge of the medicine 
chest, closet or shelf, and in sickness only such 
remedies should be taken out as are needed for the 
case in hand, and somewhat similar precautions 
should be observed with whatever is thus in use. 

Medicines, and all apparatus used in their prepa- 
ration, should be kept out of the patient's sight, 
excepting for just what time is required for actual 
administration. All spoons, glasses, measures and 
other utensils used in connection with medicines 
should be kept scrupulously clean. Medicine bot- 
tles should be occasionally wiped off with a damp 
cloth, and when corks or stoppers get sticky or 
otherwise unpleasant they should be replaced by 
fresh ones. If a disagreeable taste can be disguised 
by a pleasant and harmless flavoring substance it 
should always be done. A small piece of candy will 
often induce a child to take its medicine without 
fretting or trouble, while without it an unpleasant 
scene, harmful to the patient and trying to the nurse, 
cannot be avoided. 

One of the most troublesome problems connected 
with the giving of medicine is to find the proper 
dose for a child at any given age. Dr. Young's 
method, epitomized as "Age over age, plus twelve," 
is one of the most widely known methods of solving 
this problem. The age is used as the numerator, 
and the age, plus twelve, as the denominator of a 



MEDICINAL REMEDIES AND THEIR DOSES. 9 1 

fraction which represents the proper part of the 
adult dose to be given the child in question. To 
illustrate : suppose the child is four years old. Four 
is the numerator and sixteen (four plus twelve) 
the denominator, and the resulting fraction, four- 
sixteenths (4-i6=j4)> reduced to its lowest terms, 
gives the proper part of the adult dose for the four- 
year-old child; hence it receives one-quarter of the 
adult dose. 

By Dr. Cowle's rule, the age at the next birthday 
is used as the numerator and twenty-four as the 
denominator of a determining fraction. In other 
words, one-twenty-fourth of the adult dose for each 
year of the child's age at its next birthday gives 
the proper dose. Suppose the child is five years old. 
It will be six at its next birthday, hence its proper 
dose is six-twenty-fourths, or one-fourth of the 
adult dose. Many people prefer Dr. Cowle's rule, 
the doses averaging somewhat smaller than under 
Dr. Young's method, but usually proving abundant- 
ly sufficient. 

Of course, a proper degree of judgment and 
common sense must be used in the application of 
these rules. A large, hearty child of four may 
require as large a dose as a puny weakling of eight, 
and if there is any known peculiarity of the child 
in regard to certain drugs this must be taken into 
consideration. 

Children bear opiates badly, hence doses of this 
class of remedies must be smaller than either of the 



92 COLDS^ COUGHS AND SORE THROATS. 

above rules would indicate, while, on the contrary, 
their doses of the ordinary purgatives must be con 
siderably larger than the rules would allow. 

In speaking of particular medicines, they will 
be referred to in alphabetical order. All of the 
remedies here spoken of are mentioned in the body 
of the book in connection with one or more of the 
diseases in which they are used. 

Albolene, or Liquid Vaseline, Of very great 
value as a protective to the mucous membranes of 
the nose and throat. Should be applied from an 
oil atomizer, or nebulizer, as it will quickly clog 
an ordinary atomizer. May be used to protect the 
tissues and prolong the effect of constringing ap- 
plications such as adrenalin chloride, but is a very 
useful means of preventing colds without other ap- 
plications of any kind. If on damp and foggy 
mornings the nasal passages are cleansed by the use 
of some mild alkaline spray, or by merely sniffing 
water into the nostrils from the hand and then blow- 
ing the nose, and albolene is applied before going 
into the colder outside air, the tendency to take 
cold will be largely counteracted and overcome. 
To those who breathe the smoky and often damp 
and impure air of our larger cities, the use of albo- 
lene as a preventive of colds is worth a large amount 
of good hard cash and repays a hundredfold or 
more the slight expense and trouble involved. 

Albumen. White of tgg. An article of diet 
rather than a medicine. Of much use when a pa- 
tient cannot take milk, or fails to derive benefit 



MEDICINAL REMEDIES AND THEIR DOSES. 93 

from it. Prepared by straining the whites of two 
or three eggs through a cloth and mixing with an 
equal quantity of water. May be flavored with 
lemon juice, or used as a vehicle for stimulants 
such as whiskey or brandy. From Dr. Osier we 
get the following prescription for the use of chil- 
dren. Stir the whites of two or three eggs in a 
pint of water, with a teaspoonful of brandy and a 
little salt. Children will usually take this freely, 
and it is both stimulating and nourishing. 

Adrenalin Chloride, The solution of adrenalin 
chloride, one to one thousand, comes in dark colored 
one-ounce bottles, enclosed in neat pasteboard boxes. 
It should be kept in a cool, dark place and used 
with much care to avoid waste. Only sufficient 
for one day's use should be prepared at one time. 
It is somewhat expensive, but a very little goes a 
long way, and the relief it affords in congested 
conditions of the respiratory mucous membranes 
is wonderful. One part of the solution to ten parts 
of water is usually abundantly strong, and for the 
larynx and bronchial tubes still greater dilution is 
advisable. By using the medicine dropper, taking 
it one-third full of the solution and adding this 
amount to three or four dropperfuls of water, small 
quantities may be easily prepared, and an ounce 
will last for a long time. This dilution may be 
applied to the nasal passages by an atomizer, which 
is the best way, or by dropping it in from a medi- 
cine dropper, applying with a camel's hair brush 



94 COLDS^ COUGHS AND SORE THROATS. 

or cotton swab, or by merely sniffing it up from the 
hand. This application should be followed by one 
of albolene, as this greatly prolongs the relief and 
is in itself a great protective. The adrenalin chlo- 
ride solution should not be used more than four or 
five times a day, and usually this is more than suffi- 
cient. In bleeding from the nose this same dilution 
will check the hemorrhage almost immediately, and 
is one of the best remedies at our command. Where 
the deeper respiratory passages are to be reached 
it must be applied in the finest possible spray, direct- 
ed to the back of the throat, and the breath must be 
drawn deeply in at the same time. 

Ammonia. Chloride of ammonium is one of the 
standard remedies for coughs and bronchial trou- 
bles. Its great field of usefulness is when consider- 
able matter is secreted, but of a sticky, viscid char- 
acter, so that it is coughed up with difficulty. When 
the cough becomes loose and the matter is easily 
raised the chloride of ammonium should be discon- 
tinued or given at much greater intervals. It may 
be given in lozenges or tablets containing five grains 
each. One or two of these tablets make a good- 
sized adult dose, to be taken every four hours, 
and a good drink of water must always be taken 
at the same time to avoid irritant action on the 
stomach. For a child of two years old, one or 
two of the five-grain tablets may be dissolved in 
twenty-four teaspoonfuls of water, and a teaspoon- 



MEDICINAL REMEDIES AND THEIR DOSES. 95 

ful of the mixture, well diluted, given every two 
hours. 

Antiphlogistine, Antiphlogistine, used as a 
dressing in inflamed conditions of the lungs, comes 
in cans, which are set in warm water until the con- 
tents are thoroughly warmed, when a heavy layer 
is spread on a piece of cloth cut to fit the affected 
part, which should be well covered in. It is often 
used in pleurisy and pneumonia, and for strong, 
hearty patients is of much use. For weakly pa- 
tients or children its advantages are considered 
doubtful, and a lighter dressing is to be preferred. 

Asafoetida. A drug most obnoxious as to odor, 
but in the form of Dewee's carminative, and the 
mixture of asafoetida, very useful notwithstanding 
the scent. Dr. Anders considers the mixture of 
asafoetida highly beneficial in whooping cough. 
He gives it in doses of a half teaspoonful to a child 
of four years, repeated every two hours. This dose 
might be reduced somewhat. 

Atropine. This, or any other form of bella- 
donna, is to be used with caution, and in case of 
children, only under medical direction. As atropine 
sulphate or the solid extract of belladonna are found 
in our most effective coryza tablets, a knowledge of 
their action is desirable. Coryza tablets are usually 
directed to be taken at intervals of a half hour, 
an hour, or two hours, according to the amount of 
atropine contained, until the throat begins to feel 
slightly dry, then at longer intervals so as to main- 



96 COLDS^ COUGHS AND SORE THROATS. 

tain this effect. Signs of greater sufficiency are a 
peculiar bright redness of the cheeks and dilation 
of the pupils. In treating colds, the first symptom, 
dryness of the throat, should not be exceeded, and 
even this should not be allowed to become very 
marked. 

Calomel, One of our best remedies for over- 
coming the constipation that so frequently accom- 
panies respiratory diseases. Administered accord- 
ing to modern methods, salivation is hardly possible. 
Best given in four to six doses, at intervals of a 
half hour or hour, the last dose to be followed in 
two or four hours by a rousing dose of salts. Tab- 
let triturates are the best form, containing for an 
adult from a quarter to a half grain of calomel and 
a small amount of sodium bicarbonate (common 
baking soda). Of these six may be taken at hourly 
intervals and be followed by the salts as above 
mentioned. A favorite mode is to take the tablets 
so that the last dose falls at bedtime, then take 
the salts on awaking next morning. For children 
delightful little tablets are made containing calomel 
and aromatics. These are of a pinkish color, taste 
like candy, and are eagerly eaten by the little patient 
without a thought of their being medicine. These 
tablets usually contain one-tenth grain of calomel 
and are taken at the same intervals as in case of 
the adult. For infants under one year, a single 
tablet (one-tenth grain) may be broken into four 
or six parts, each part representing one of the bro- 



MEDICINAL REMEDIES AND THEIR DOSES. 97 

ken doses, and for children castor oil is more com- 
monly used than salts. In small children, under 
two years, the castor oil may be replaced by olive 
oil, which is sweet and nutritious, and a laxative 
of no mean value. 

C. C, Pills. Compound Cathartic Pills. A rather 
harsh, but very effective and handy cathartic medi- 
cine. Adult dose, one to three pills at bedtime. 

Castor Oil. One of the good old home remedies. 
Good, however, does not apply to the taste. A 
tablespoonful is an average dose for an adult. A 
teaspoonful will do for children from one year up 
to five or six, and two teaspoonfuls (or a desert- 
spoonful) up to the age of ten or twelve. If the 
dose given does not operate in four or five hours, 
it may be repeated. 

Camphor, Camphor gum is sometimes used in 
a pocket inhaler, or a small lump is kept in a box 
or bottle and occasionally sniffed at. In this way 
it does some good in a mild cold or headache. In 
either condition a bottle of the spirits of camphor 
is more effective. Camphorated oil is a good ap- 
plication for the chest and neck of a child suffering 
from bronchitis, pneumonia or croup, and either this 
oil or the camphor liniment acts well when rubbed 
into the painful muscles in la grippe, tonsillitis, or 
other affections characterized by aches and pains. 

Epsom Salts. See ''Salts and Salines.'' 

Fever Pozvders. Fever or Headache Powders 
afford a fine example of the abuse of a good thing. 



98 COLDS, COUGHS AND SORE THROATS. 

Acetanilid is the commonest active ingredient and 
its value is unquestioned. Given, however, in huge 
doses by well-meaning people, who only know that 
it will reduce fever promptly and surely, it has 
undoubtedly occasioned loss of life and years of 
sickness and misery. Have nothing to do with fever 
powders, unless a thoroughly good physician tells 
you exactly how to use them. 

Flaxseed Tea, This friend of our childhood is 
a pleasant and useful addition to the treatment of 
any form of sore throat. To prepare it, add three 
heaping teaspoonfuls of flaxseed to a little over a 
half pint of boiling water. A teaspoonful of pow- 
dered gum arabic should be added and it may be 
flavored with lemon. It should be set on a warm 
part of the stove for an hour or two, but must 
not be allowed to boil. 

Guaiac. Gum guaiac is highly esteemed in dis- 
eases of the throat. Five-grain guaiac lozenges 
may be procured, and one of these allowed to slowly 
dissolve in the mouth, thus reaching all inflamed 
parts. For children the lozenges may be divided 
to give the proper sized dose. The ammoniated 
tincture of guaiac is considered highly efficacious 
in cases of sore throat and will frequently cure a 
chronic pharyngitis. Small and frequently repeated 
doses will sometimes entirely check an oncoming 
attack of tonsillitis. Adult dose from ten drops to 
a teaspoonful. Its very disagreeable taste renders 
it impossil)le for some persons to take. 



MEDICINAL REMEDIES AND THEIR DOSES. 99 

Iron, A most popular and useful tonic. Usually 
employed in the form of the tincture (Tincture 
Ferri Chloridi). The adult dose is ten. to thirty 
drops, usually taken three times a day after meals. 
It should be well diluted and taken through a glass 
tube in order to avoid injury to the teeth. 

Syrup of the Iodide of Iron. A very useful form 
of iron for children. It should always be given 
in plenty of water and is usually taken three times 
a day, after meals. Half of a drop for each year 
of the patient's age, up to ten years, is about the 
right sized dose. 

Menthol Obtained from peppermint and some- 
times called Mint Camphor. One grain of menthol 
dissolved in an ounce (two tablespoonfuls) of wa- 
ter, and applied by means of an atomizer, markedly 
relieves congestion of the nasal passages in coryza. 
Three grains in a half ounce (one tablespoonful) 
of albolene, and applied by an oil atomizer, gives 
even better results. If used too freely headache 
is apt to follow. 

0/7^. External Use. The external application of 
oily substances is a form of medication that has 
not received the attention it deserves. The un- 
avoidable soiling of clothing has undoubtedly ren- 
dered it less popular than its merits warrant. Olive 
oil, goose grease, codliver oil, and various animals' 
fats are used for this purpose, and weakly children 
sometimes improve most wonderfully under this 
treatment. Where it is desired to make use of 

L.OFC 



100 COLDS, COUGHS AND SORE THROATS. 

inunction, the child should be undressed, before a 
good fire in winter, in the warm sunshine in sum- 
mer, and the whole body, excepting the head, thor- 
oughly annointed. The oil should be allowed to 
soak in for twenty minutes or longer, aided by 
gentle massage if desired. After this the child 
should be well rubbed with soft, warm rags until 
the oil is removed, and a suit of old underclothing 
may be used until time for the daily bath. This 
method may be varied as desired, but the main 
points are, to use good, pure oils, animal fats as 
a rule, and allow them to soak in under the influence 
of warmth for some little time, aiding by massage 
if desired. 

Onions, The homely old onion is believed to 
have great influence over diseases of the respiratory 
tract, and many mothers rely entirely on this honest 
and odoriferous vegetable in their treatment of 
colds, coughs and sore throats. Onion syrup is the 
form in which it is most frequently used. This is 
prepared by cutting up one or two large onions 
in rather chunky pieces, which are placed in a large 
cup or a bowl and sprinkled thickly with sugar. 
As the juice exudes it mixes with the sugar, form- 
ing a syrup, which is given as it forms, in spoonful 
doses. If the case is mild use one onion, if bad two 
or more of the bulbs. In bronchitis it will often 
exercise a most beneficial influence. The onion 
poultice is another favorite preparation, often used 
in conjunction with the syrup. To form this the 



MEDICINAL REMEDIES AND THEIR DOSES. lOI 

onions are sometimes partially boiled and made into 
a pasty mass, which is placed between two layers 
of cloth and applied as warm as it can be borne 
with comfort. Sometimes the raw onions are 
pounded to a pulp, which is applied in the same 
manner. Garlic soup, made by boiling garlic in 
milk, is often given with asserted advantage in 
chronic colds. The milk is strained off and given 
to the child as a drink. 

As an article of diet, onions are credited with 
marvelous powers in the prevention of respiratory 
diseases. To what extent this belief is justified, 
the author has never been able to determine. It 
is so widespread that there must be some foundation 
for it, but the writer's experience, personal and 
professional, has not been satisfactory in this re- 
spect. 

Quinine. This is one of the good old stand-byes. 
Its chief use in diseases of the respiratory tract is 
as a tonic, and as a tonic it is strictly first class. 
A cold may often be checked by a full dose of 
quinine taken at the first appearance of symptoms, 
and where there is a marked tendency to take cold 
easily, small doses of quinine once, twice or three 
times daily, will often enable the system to overcome 
this tendency. When a cold has been checked, 
small tonic doses three times a day for . a week 
are advisable. If unusual exposure is to be under- 
gone, a good dose of quinine, taken before the 
exposure occurs, will often enable the person to go 



I02 COLDS, COUGHS AND SORE THROATS. 

safely through what would have inevitably resulted 
in some form of cold without this precaution. The 
Standard full dose of quinine is ten to fifteen grains, 
but this varies greatly according to individual pecu- 
liarity. Five grains or even less will be a full dose 
for one person, while fifteen or twenty is only mod- 
erate dosage for another. 

Salts and Salines. By salts, we ordinarily mean 
Epsom salts. Its purgative action is well known, 
and it has been a household remedy of great 
value for generations. A heaping tablespoonful in 
a cup of warm water is the average adult dose. Of 
other salines, Rochelle salts is almost as familiar 
as Epsom salts. It may be taken in somewhat 
larger dose than the Epsom salts, but is more apt 
to disorder the stomach. Many efifervescent salines 
are offered as substitutes for the good old Epsom 
remedy, and some of them are fully as efficient and 
much more agreeable, both as to taste and mode of 
action 

SaloL An intestinal antiseptic of much value. 
It is supposed to have a peculiarly good effect in 
rheumatic conditions, tonsillitis and certain forms 
of sore throat. The adult dose is five to ten grains 
three or four times daily. It should be taken 
preferably an hour or two after meals. Used after 
cathartic remedies its effects are excellent, and it 
deserves to be more widely used. 

Sulphocarbolates. The sulphocarbolates of cal- 
cium, sodium and zinc are very efficient and satis- 



MEDICINAL REMEDIES AND THEIR DOSES. IO3 

factory intestinal antiseptics. Whenever the bowel 
evacuations are unusually offensive they should be 
used until all such offensiveness is removed. In 
many cases where ^'bloating'' or an unpleasant feel- 
ing of fullness after eating occurs, a few small 
doses of sodium sulphocarbolate will remedy the 
condition completely. Sodium sulphocarbolate is 
the most generally useful and most easily taken 
of the three. The calcium salt is supposed to be 
especially useful in rhacitic or otherwise illy de- 
veloped children, and the zinc sulphocarbolate when 
diarrhoea is obstinately present. The dose of any 
one of them is from five to ten grains, taken an hour 
or so after eating. In serious conditions these doses 
may be taken much more frequently for short peri- 
ods, or until the conditions are modified. 



The above is not intended as an exhaustive refer- 
ence to remedies found useful in diseases of the 
respiratory tract. Such reference would require a 
book of itself, and a large book at that. Here the 
object has been merely to speak more at length of 
a few useful remedies than was practicable under 
the heading of any special disease in which one or 
more of the medicines spoken of may be found 
useful. 



PART II. — Respiratory Diseases and Their 
Treatment. 



CHAPTER VIL 

COLD IN THE HEAD. 

CoRYZA. Acute Nasal Catarrh. Acute 
Rhinitis. 

The old familiar cold in the head is also known 
as acute nasal catarrh, acute rhinitis and coryza. 
For the sake of brevity we shall call it by this last 
and shortest name. Coryza is familiar to us all. 
Scarcely one in a million of our entire population 
but has experienced it; a very few once or twice 
in a lifetime, many more two or three times a year, 
while other unfortunates hardly recover from one 
attack before another is on hand. 

The usual definition of coryza is ''An acute in- 
flammation of the nasal mucous membranes." The 
nasal passages are the air channels which extend 
through the external or visible nose, and continue 
for nearly, or quite, two inches further backwards, 
at which point they open into the naso-pharynx, 

104 



COLD IN THE HEAD. IO5 

or upper part of the throat. The nasal mucous 
membranes line these passages throughout their 
entire extent, so that considerable surface is involv- 
ed in an ordinary cold, and it is emphatically "in 
the head/' 

Lowered vitality predisposes strongly to coryza. 
Moreover, the usual condition of the nasal mem- 
branes has much to do with taking cold. These 
delicate tissues are exposed to greater changes of 
temperature, more dust, smoke and other airborne 
impurities, and generally to greater contact with 
the coarseness of the outer world than is the case 
with any other of the mucous membranes. Owing 
to this constant exposure to influences which in 
civilization are unnaturally harsh, the best authori- 
ties believe that in the greater number of cases the 
nasal membranes are in a state of chronic or con- 
tinuous inflammation, so slight in degree as ordi- 
narily to pass unnoticed, but sufficient to offer a 
point of least resistance where circulatory disorders 
may most easily manifest themselves. 

Any of the ordinary exciting causes of colds will 
bring on coryza. Getting the feet wet is a widely 
recognized cause, and even getting them chilled, 
as from a damp pavement, is frequently sufficient. 
Exposure to drafts, getting caught in a shower of 
rain, an attack of indigestion, sometimes merely 
the change from country air to a city atmosphere, 
variations in the weather or imprudent changes in 



I06 COLDS^ COUGHS AND SORE THROATS. 

the underclothing, are among the commoner excit- 
ing causes. Sometimes the disease seems to be 
epidemic; that is, it spreads through a whole com- 
munity. At other times it seems to be contagious, 
and many instances are cited in which it has spread 
from person to person. Probably in these cases the 
contagion is due to the later sufferer breathing air 
which has been contaminated by passing through 
the respiratory passages of a prior victim to coryza. 
In view of these facts, belief is gaining ground in 
the existence of a particular microbe, or more proba- 
bly of a number of organisms, the activity of any 
one of which may result in coryza. 

It is also well to bear in mind that what appears 
to be a simple coryza may be the first stage of some 
more serious disease, as measles, la grippe or whoop- ' 
ing cough. In any event, the attempt should be 
made to check it as if we knew it to be neither 
more nor less than a cold in the head, but we should 
remember this possibility lest some lurking foe take 
us by surprise and gain firm foothold ere we sus- 
pect its presence. The likelihood of such an occur- 
rence is, of course, vastly greater when contagious 
diseases, such as those named, prevail in the neigh- 
borhood. 

The initial symptoms of coryza' vary in different 
cases. Sometimes an attack commences with sneez- 
ing, two or three severe sneezes being the first inti- 
mation of a cold. In other cases sneezing is pre- 



COLD IN THE HEAD. lO/ 

ceded by a feeling of general discomfort, shortly 
followed by ''cold creeps" up and down the back, 
or some other manifestation of chilliness. Rarely 
there may be a distinct chill. At first the nose 
and perhaps the throat feel dry and uncomfortable, 
but as soon as the sneezing stage commences a 
thin, watery and often irritating discharge from the 
nostrils necessitates the almost constant use of the 
handkerchief, and frequently renders the upper lip 
below the nose very raw and tender. Headache 
and slight fever are experienced and, owing to the 
swollen and congested condition of the nasal mem- 
branes, breathing is difficult and largely through 
the mouth. In colds of unusual severity there may 
be much backache and general pains throughout 
the body and all the limbs. 

This is the time to use simple remedies, and if 
promptly applied, right at the beginning, these are 
exceedingly effective. Constipation exists in almost 
every case and, as the first and most important 
step, it must be overcome. The method differs 
somewhat according to the degree of disorder. 
Sometimes a seidlitz powder or a dose of salts will 
be abundantly sufficient, but ordinarily the best plan 
is to take two or three grains of calomel in divided 
doses, following the last dose in three or four hours 
with a good dose of some saline laxative. Calomel 
tablets of any size desired, and manufactured by 
the best chemists of the country, may be had at 



I08 COLDS, COUGHS AND SORE THROATS. 

any drug store. Six tablets, each containing half 
a grain of calomel and a little sodium bicarbonate, 
will make about the right quantity for an average 
adult. One of these tablets should be taken every 
half hour (the interval may be an hour if preferred) 
until all are used. Three or four hours after the 
last tablet, take a heaping tablespoon of Epsom 
salts dissolved in a cup of warm water. If in two 
or three hours the bowels do not move, and move 
well, repeat the dose of Epsom salts, and continue 
to repeat at intervals of two or three hours until 
they do act. A much smaller dose of salts will 
answer in some cases, and when this is known to 
be so, the smaller dose should always be used. Ro- 
chelle salts, a seidlitz powder, or any of the effer- 
vescent saline laxatives may be used instead of the 
Epsom salts if desired, and the dose of calomel 
may be larger or smaller according to individual 
susceptibility. Six quarter-grain doses may be suffi- 
cient for one person while another may require 
full grain doses. A very good combination for a 
robust patient, or one whose bowels are hard to 
move, is a quarter of a grain of calomel, a twelfth 
of a grain of podophyllin and a little soda, six tab- 
lets being used, and the salts following as in the 
other cases. If preferred, one or two of the good 
old C. C. (compound cathartic) pills may be taken 
at bedtime. As a rule salts are unneccessary when 
these pills are used. 



COLD IN THE HEAD. IO9 

Castor oil is usually the children's laxative. A 
teaspoonful or two, according to age, will generally 
prove effective, or if necessary the dose may be 
repeated in three or four hours. The compound 
licorice powder is a much pleasanter medicine and 
usually abundantly effective in doses of from a quar- 
ter of a spoonful to a half. Cascara cordials are 
usually excellent medicines for children, and the 
flavor is agreeable. They are not bad laxatives 
for grown people either, and the proper dose for 
any age is given on the label of each bottle. These 
laxative medicines are to be used as soon as the 
first symptoms of a cold accompanied by constipa- 
tion, are observed, and their use may be continued 
while the measures for producing profuse sweating, 
which follow, are carried out, as the two processes 
do not interfere with each other at all. Each of 
these modes of treatment should be instituted as 
early as circumstances will allow. 

The cold itself may be sweated out, that is to 
say, circulation and heat production may be brought 
back to natural activity and proper relationship by 
means of heat, applied externally and internally. 
When these applications result in profuse perspira- 
tion the desired result is believed to be accomplished 
and the cold is generally cured. The hot mustard 
foot-bath, combined with warm drinks and favor- 
ing drugs, is the best method of accomplishing this 
and it is managed as follows, preferably at bed- 
time, though it may be used at any time of day. 



no COLDS^ COUGHS AND SORE THROATS. 

A small tub, or a large pail, nearly filled with 
water as hot as can be borne, is set before the fire- 
place, the open oven door, or whatever other pecu- 
liarly warm and comfortable spot the house affords, 
near enough the patient's bed for him to get from 
bath to bed without the slightest danger of being 
chilled. If from a teaspoonful to several heaping 
tablespoonfuls of ordinary ground mustard be 
stirred in the hot water it makes it that much better. 
Very little mustard is sufficient for a thin-skinned 
person. 

The patient, barefoot, but otherwise warmly clad, 
or wrapped in blankets, sits beside the pail, and for 
from twenty minutes to half an hour bathes and 
soaks the feet and legs, hot water being added 
from time to time so as to keep the temperature 
as high as he can bear it. The bath completed, 
feet and legs are rubbed quickly and vigorously 
until thoroughly dry with a warm, soft towel and 
the patient gets quickly into a well warmed bed 
between blankets, drinks a tumblerful of hot lemon- 
ade with a dash of good whiskey, or a teaspoonful 
of sweet spirits of niter added, takes ten to fifteen 
grains of quinine, if so large a dose can be borne, 
and keeps snugly tucked in while the sweating pro- 
gresses and until sleep comes. Some persons will 
find this dose of quinine entirely too large, and 
when this is known to be the case a smaller quantity 
should be used. Of course, for children the dose 



COLD IN THE HEAD. Ill 

should be considerably smaller. Five grains of 
Dover's powder, or, if the patient be a robust adult, 
better ten, may be taken instead of the lemonade 
or in addition to it. There must be no chilling or 
checking of perspiration at any stage of the pro- 
cedure, the bedclothes must be light but warm, 
somewhat more in quantity than the usual amount, 
and tossing them off must be avoided. The object 
is to cause plentiful sweating and it must cease 
naturally and without being checked. The sweat- 
ing will probably be profuse in less, often consider- 
ably less, than an hour after going to bed. 

There are various modifications of the hot foot 
bath, the pleasantest and best perhaps being Bos- 
worth's, as follows : The patient is divested of cloth- 
ing, warmly wrapped in blankets, and then takes 
the foot bath as above described, sipping his hot 
toddy while soaking his feet and keeping on with 
the bath until perspiration is fully developed. He 
may also take the quinine and Dover's powder 
while the bath is in progress. When sweating is 
profuse, this being the evidence of re-established 
circulatory equilibrium, he is carefully and com- 
pletely dried by brisk rubbing with coarse towels, 
and the rubbing is continued until he is not only 
dry but the skin is in a warm glow, when he again 
wraps up in dry blankets, or if so inclined, goes 
immediately to bed. There will be no harm in 
sitting up a little longer if so disposed, but there 



112 COLDS, COUGHS AND SORE THROATS. 

must be no chilling. It is not desirable that per- 
spiration should occur after going to bed, but it 
cannot always be avoided. However, there is no 
need for more than the usual amount of bedclothes. 
Any form of bath that will produce free perspira- 
tion answers all requirements, the full bath, hot air- 
bath, or whatever else may be preferred, but as a 
rule the foot bath is the more convenient and prac- 
ticable mode of inducing profuse diaphoresis. 

Next day the patient will in all probability be 
well, and if need be he can go about his ordinary 
business. Care must be taken, however, to avoid 
a fresh cold, and if the weather is bad it might be 
better if a day, or a part of a day, could be spent 
in doors. In any event he should take two or three 
grains of quinine three times a day for about a 
week, it being a mild and effective tonic supposed 
to be particularly antagonistic to colds. This is 
the good old standard treatment, and if taken soon 
enough will knock forty out of forty-one colds 
higher than a kite. 

To those who are so situated that the above 
treatment is impracticable, we would recommend 
the ''Traveler's Treatment," given in full in the 
latter part of this chapter. It may be said briefly 
here that a full dose of laxative medicine should 
always be taken at the first opportunity. Very often 
this and the use of any good coryza tablet will 
be sufficient to dispel an incipient cold. Some per- 



COLD IN THE HEAD. II3 

sons find quinine, in as large doses as can be toler- 
ated, an almost certain cure. Others find five or 
ten grains of Dover's powders, taken on going to 
bed, a reliable remedy. 

Among the cowboys a heroic, but usually effect- 
ive m.ode of treatment for colds was to take several 
of the compound cathartic pills, followed by two 
or three of the largest capsules they could get hold 
of, two-thirds full of quinine, one-third full of 
cayenne pepper. Both cap and body of the capsule 
were so tightly packed (the body of the capsule 
with quinine, the cap with pepper) that they were 
joined with difficulty. This monstrous dose was 
repeated in two or three hours, or on going to bed, 
and was very likely to break up the cold. With 
doses reduced to suit less robust individuals, the 
mode of treatment is good, and may be easily 
adapted to individual requirements. 

When a cold is allowed to run its course, or fails 
to yield to late or imperfect treatment, or hangs 
on by reason of repeated exposures, or for any 
other cause, probably the greatest discomfort arises 
from the congestion and swelling in the nasal pas- 
sages. This causes stuffiness, difficulty in breathing, 
and an unpleasant discharge, at first watery and 
flowing almost continuously, but later on becoming 
so thick and tenacious that it is only gotten rid of 
by vigorous nose-blowing or the use of douche, 
atomizer or other cleansing device. When this con- 



114 COLDS, COUGHS AND SORE THROATS. 

dition prevails, a relief which is simply marvelous 
is obtainable by the use of solutions of cocaine or 
adrenalin chloride. The adrenalin is preferable as 
being free from danger and unpleasant after effects, 
as effective as the cocaine or even more so, and 
without the slightest danger of inducing a drug 
habit. 

Adrenalin chloride comes in liquid form in what 
is known as the one to one-thousand solution, in 
one-ounce bottles, and should be kept from heat and 
too much light to avoid chemical change and de- 
terioration. One part of the adrenalin solution 
should be added to eight or ten parts of water, the 
purest that can be obtained. It is better to boil 
the water and allow it to cool before using, and 
it is claimed that a small amount of salt, a scant 
teaspoonful to a quart, added before the boiling, 
improves the water for this use. Only enough of 
the adrenalin solution for present use should be 
prepared at one time, say a teaspoonful or two. 
To get the right proportions a graduated medicine 
glass may be used, but probably the easiest and 
quickest method is to use one of the small medicine 
or eye-droppers found in all drug stores. If this 
plan is followed, fill the dropper half full of the 
adrenalin chloride solution and empty into a small 
vial. Then add four or five droppers full of water 
to get the eight or ten volumes required, and the 
fluid is ready for use. It may be desirable in a 



COLD IN THE HEAD. IIS 

given case to make the solution weaker or stronger, 
but this is a good strength for a first trial and is 
sure to give relief. 

When the solution is used the nostrils should 
first be cleansed by gently blowing the nose if that 
will suffice. If not, warm water (it is better to 
add a pinch or two of soda to each cupful) may 
be sniffed up the nostrils and expelled until they 
are sufficiently clear of mucous, or an atomizer or 
douche may be used with any mild alkaline wash. 
The adrenalin solution is most conveniently applied 
by means of an atomizer, but very gratifying re- 
sults are obtained by using it with a small swab, 
formed by wrapping a bit of cotton around the end 
of a match. Dip this into the solution and thrust 
it into each nostril in turn, at the same time inhaling 
gently. After an interval of a minute or two, re- 
peat the process in order to reach the parts at first 
hidden, but now exposed by reduction of the 
swelling. 

These applications may be made three or four 
times daily, but should be used with some caution, 
as, if too frequent, they cause headache. The good 
effect is prolonged by following the use of the 
adrenalin solution by a similar application of albo- 
lene (liquid vaseline), which may be used either 
in an oil atomizer or by the swab. The albolene 
protects the delicate membranes from dust and 
other irritants, and to some extent from the cold, 



Il6 COLDS^ COUGHS AND SORE THROATS. 

as well as remedying dryness and harshness. If 
the albolene is not used the patient should not go 
out into the cold for some little time after the ap- 
plication of the adrenalin spray, or fresh cold will 
be caught. The addition of from three or four up 
to ten or twenty grains of menthol to each ounce 
of liquid greatly improves albolene for this use, 
as the menthol prolongs the relief and also exer- 
cises a decided soothing and curative influence of 
its own. 

Both the solution of adrenalin chloride and the 
albolene may be applied by means of the little medi- 
cine or eye-droppers already referred to, or any 
other spray treatment may be given in this manner, 
the patient lying down and turning the head from 
side to side, so as to favor the application. 

The pocket inhalers found in all drug stores 
usually containing menthol come in handily here, 
and materially lighten the discomfort of a cold. 

To relieve the excoriated and tender upper lip, 
cleanse thoroughly and apply any simple ointment. 
Cold cream is excellent, vaseline answers well, sweet 
oil will do, or any mild, unirritating substance of an 
oily or greasy nature may be used. 

In an ordinary coryza, the fever is usually too 
slight to require much attention, and with the relief 
of the other symptoms it disappears. Cool water 
to drink, and, in severe cases, an occasional spong- 
ing of arms and chest, form all the treatment that 
is apt to be needed. 



COLD IN THE HEAD. II7 

Headache in connection with coryza is rarely 
severe enough to be important, and generally yields 
to the treatment designed for the general condition. 
Occasionally, owing to involvement of the frontal 
sinus, it overshadows other symptoms and calls for 
a physician's care. Ordinarily, however, smelling 
salts, spirits of camphor, inhaled and applied ex- 
ternally, or compresses kept wet with cool or hot 
v/ater, are all that will be needed. Bosworth says 
that a compress wrung out of water as hot as can 
be borne, applied to the forehead, and continually 
renewed as it cools, will often not only relieve the 
local symptoms but even cure the cold. If either 
hot or cold applications are noticeably uncomfort- 
able to the patient, stop their use at once. 

If a cold has several days' start the treatment 
of the special symptoms just described should be 
followed. Constipation, if it exists, demands a 
cathartic; coryza tablets (see pages 118-121) may 
be taken in strict accordance with the directions for 
the brand used. If needed, the adrenalin chloride 
solution, followed by albolene, may be applied as 
directed, and a Dover's powder at night will help 
the good work to some extent. In addition to these 
remedies, take rather large tonic doses of quinine, 
three to five grains, three times a day, and even if 
the cold is not completely cured its discomforts will 
be decidedly alleviated and its duration shortened. 

A "Traveler's Treatment" of coryza must of 



Il8 COLDS, COUGHS AND SORE THROATS. 

necessity vary somewhat from that laid down. We 
have said that the prompt use of a cathartic and a 
hot foot bath will break up nine out of ten colds. 
But suppose one feels a cold coming on when forty, 
fifty, or maybe five hundred miles from home and 
among strangers — possibly in some backwoods 
shanty where so much hot water as a whole pailful 
at one time is an unheard of quantity, not to be 
procured except on infrequent wash days or at hog- 
killing time — must the victim necessarily give up 
and suffer the cold to run its course? By no man- 
ner of means. An assortment of remedies may be 
carried in very small compass sufficient to drive out 
any ordinary cold, if taken promptly in its earliest 
stages. 

Let us suppose that when packing for your jour- 
ney you have had the wisdom, as every traveler' 
should, to put a few of the more frequently needed 
medicines in grip or suit case, but not in some un- 
get-at-able trunk or box of luggage. You may have 
put in both calomel and Epsom salts, or you may 
have chosen in their place a box of C. C. (compound 
cathartic) pills, a very effective but somewhat harsh 
remedy. You should also have quinine in two or 
three-grain capsules, and Dover's powder, put up 
in five-grain powders ready for use. In addition 
you should have some good make of coryza or 
rhinitis tablets, such as may be found in any good 
drug store. 



COLD IN THE HEAD, 1 19 

A common and very excellent formula for these 
is the one containing from one-eighth to one-quar- 
ter of a minim of the fluid extract of belladonna 
root, or an equivalent amount of atropine sulphate, 
and a grain each of quinine and camphor. Pro- 
portions may be varied, but with these ingredients 
we get a very effective tablet. The formula and full 
directions should be on each package of the remedy. 
If you get less than a package, see the formula 
anyhow, and get the directions very carefully. 
With the atropine or belladonna tablets, the direc- 
tions will probably be somewhat on this order: 
''One or two tablets every half hour (or it may 
be every hour or every two hours) until the throat 
feels dry, after which take one or two tablets every 
five or six hours until six doses have been taken." 
The sensation of dryness in the throat must not 
become very marked, and if at any time it does, 
or if the face is much flushed, make the intervals 
quite a little longer between doses, or stop taking 
them altogether. There are excellent coryza tab- 
lets and granules on the market which depend on 
other drugs than atropine for their activity, but 
whatever tablet you get, make sure of your direc- 
tions and then follow them. 

On the first suspicion of a cold take the proper 
dose of your coryza tablets, and fifteen or twenty 
minutes later take your cathartic medicine. If you 
prefer the C. C. pills, one to three is the regular 



I20 COLDS^ COUGHS AND SORE THROATS. 

dose, but the average individual will find three 
entirely too many. At bedtime take five or ten 
grains of Dover's powder. Quinine should be taken 
too, as directed in the home treatment of a cold, 
but if your coryza tablets contain quinine and atro- 
pine, reduce the dose of quinine, taking, say from 
three to six grains. Then you may go to sleep with 
an easy conscience; you have done your duty and 
probably cured the cold. 

With some individuals quinine by itself, either 
in a single dose of ten to fifteen grains, or in a half 
dozen smaller ones of two to three grains each, is 
sufficient to break up a cold. In other cases a ten- 
grain dose of Dover's powder taken on going to 
bed is all that is necessary. Or again, these two 
may be combined, and quinine and Dover's powder 
work together as kindly as two old plow horses. 
Add to this team a lively little old lead mule, in 
the shape of a brisk cathartic, and you have an outfit 
that will mighty near jerk Mr. Coryza out of his 
boots any day of the week at all, or even on a 
Sunday. All three of these remedies are easily 
procured, easily carried and easily taken. The 
coryza tablets may be added to the list without 
trouble, and then you have a strong combination, 
which will prove effective for a large proportion of 
cases. 

Frequently coryza tablets alone are markedly 
successful in the treatment of coryza, and personally 



COLD IN THE HEAD. 121 

I have many times checked an oncoming cold by 
a single dose containing the one-hundred-and- 
twentieth part of a grain of atropine. Other per- 
sons depend on the hot foot bath, with or without 
hot drinks, and still others make different combina- 
tions of various parts of the regular treatment. It 
is essential for the success of these partial treat- 
ments that they should be used in the early stages. 
Of course if you know that one, two or more of 
these parts are all that you need, there is neither 
use nor sense in taking the v/hole treatment. 

Sometimes a cold hangs on and on, ''and will 
not down,'' and there is no obvious reason for this 
persistence. In a child this should give rise to a 
suspicion of adenoids (see Chapter VIII), and if 
other confirmatory symptoms are noted an exami- 
nation by a thoroughly good physician should be 
made. If adenoids are not found, or in the cases 
of either children or adults where it is known that 
no such condition exists, tonic treatment should be 
promptly inaugurated. The tonics given in the 
following list may be easily obtained, and will gene- 
rally be found satisfactory. 

For a child, codliver oil and the syrup of the 
iodide of iron can hardly be excelled, and the cod- 
liver oil is a good tonic for adults as well. These 
remedies should always be accompanied by plenty 
of out-of-doors exercise, with an abundance of 
nutritious and easily digested food, and the general 
health should be carefully looked after. 



122 COLDS, COUGHS AND SORE THROATS. 

According to age, a half teaspoonful to two tea- 
spoonfuls of codliver oil will be a good dose for a 
child. For an adult from a tablespoonful to two 
or three times this amount may be taken. It is 
best to take small quantities when beginning its 
use, and it is advisable that at the first a single 
dose be given just before bedtime. Afterwards a 
dose may be given at this time and also an hour 
or two after breakfast, and as tolerance is estab- 
lished a dose may follow each meal (an hour or 
two after eating is the best rule), and precede going 
to bed. If the patient is nauseated, or unable to 
digest the oil, harm rather than good is being done, 
and if smaller doses or change in the time of ad- 
ministration fail to correct these evils, the oil must 
be given up and other tonics used. 

Various expedients are adopted to disguise the 
taste of codliver oil or overcome the repugnance 
to it. A child may often be bribed to take the dose 
by a small peppermint lozenge before and after tak- 
ing it, while adults often find a chaser of port wine 
serviceable in removing the flavor. It is sometimes 
taken in whiskey or in milk, the oil floating of itself 
to the mid-surface of the liquid, and being taken 
without coming in contact with either the tumbler 
or the patient's mouth. 

Syrup of the iodide of iron is an excellent remedy 
for pale and weakly children, whether particularly 
subject to colds or not. It may be given in a dose 



COLD IN THE HEAD. 1 23 

of one or two drops in a few spoonfuls of water 
to a child of two years, and from fifteen drops to a 
half spoonful in a cup of water to an adult, these 
doses being taken three times a day. The external 
application of oils and oily substances may be used 
in this condition with the greatest benefit. For 
mode of application see Chapter VI, ''Medicinal 
Remedies and Their Uses." 

For older children and for adults many excellent 
tonics are found in the drug stores, containing iron, 
quinine and strychnine, or any one of them in vari- 
ous combinations. Never get them unless the com- 
ponent drugs and their proportions are specified on 
the label. In any event, it is better to ask your 
physician's advice, in order to get a medicine whose 
value lies in the substances contained and not in a 
fancy label or an odd shaped bottle; also, in order 
to ensure proper doses for the person using it. 

With some people catching cold seems to be a 
sort of habit. Hardly are they recovered from one 
before another appears, and they are almost con- 
stantly suffering from colds. 

Dr. Hare says that these unfortunate individuals 
may be divided into two classes. In sufferers of 
the one class the mucous membranes are at fault, 
being delicate and very susceptible to irritation. 
Such persons do well on small doses of arsenous 
acid, continued for weeks. In those of the other 
class, the skin is at fault, the peripheral capillaries 



124 COLDS, COUGHS AND SORE THROATS. 

lacking tone, and the Turkish bath offers a cure. 
Either of these means should be used only under 
intelligent medical direction, and the condition, 
whatever it may be, should be as promptly and as 
thoroughly remedied as is possible, for colds long 
continued, or continually renewed, undoubtedly es- 
tablish and maintain a condition favorable to the 
development of certain most dangerous respiratory 
ailments. The possibility of adenoids, as the cause 
of this super-susceptibility, should also be borne in 
mind. Such patients should also pay much atten- 
tion to general health, their diet should be nutri- 
tious and such as agrees best with their digestive 
powers, they should avoid undue exposure to cold 
and dampness, should remedy constipation or any 
other diseased condition to which they may be sub- 
ject, and in every way should strive to improve and 
tone up the general physical system. 

The tonics, codliver oil, iron, etc., recommended 
for ''Colds that will not cure," may well be em- 
ployed in this condition also. 

For a malady so nearly universal as coryza there 
must needs be many irregular methods of treat- 
ment, some fairly good, some ludicrous, some bad 
or even dangerous, and it will do no harm to de- 
vote a few pages to their consideration. 

''One-Day Cold Cures/' These are markedly 
noticeable among the irregular remedies. They 
stare us in the face at every street corner, nor is 



COLD IN THE HEAD. 125 

it even necessary that a drug store be at the afore- 
said corner. Any cigar stand, general merchandise 
store, eating house or confectionery may carry them 
in stock, and faiHng all these, the street peddlei; 
dins their reputed virtues in our ears. Some of 
these remedies contain standard and familiar drugs 
such as quinine and cascara sagrada, which can 
hardly do harm in any reasonable or probable dose, 
and their constituents are honestly proclaimed along 
with the directions. There is no harm in such a 
"cure,'' and some of them do cure, although not 
always in one day. Avoid those containing drugs 
of whose powers and uses you are ignorant, and be 
especially wary of the coal tar preparations, aceta- 
nilid, phenacetin, antipyrin and their congeners. 
All are fine medicines when used aright, but you 
cannot use them rightly unless you are thoroughly 
familiar with their powers and dangers. And never 
use a cold cure, or any other medicine, whose for- 
mula is concealed, unless you are acting under strict- 
ly professional advice. 

A method of treatment at which many of us 
have laughed, although many claim to have used 
it with success, is a stocking worn around the neck 
at night. The stocking, warm from the foot, is 
fastened about the neck on going to bed and re- 
moved on rising. Although myself preferring a 
coryza granule or two, I should use this plan if all 
else were lacking. It is much akin to the flannel 



126 COLDS^ COUGHS AND SORE THROATS. 

bandage of our childhood, and to be successful 
must be used early in the game. Its greatest draw- 
back lies in the gross injustice of making one stock- 
ing work so largely overtime. 

Deep Breathing. Occasionally some enthusiast 
will be found to claim that he can break up any 
cold in its beginning by taking deep and repeated 
breaths, with shoulders back and chest well out. 
This remedy will hardly be found an unfailing 
success, but breathing deeply through the nostrils 
is undoubtedly beneficial and may arrest a cold. 
For narrow-chested and stoop-shouldered individ- 
uals I would most heartily recommend it, and very 
much more so if they will take the cure regularly 
and persistently, long before the cold is caught. 

Back Against Fire. One of the authors of a 
previous generation assures us that any cold may 
be infallibly cured in its incipiency by standing with 
the back against the fire, or against the hot stove- 
pipe, or any similarly adequate source of heat, claim- 
ing that the cold enters at the back and the heat 
must be sent after it in the same direction. It is 
probably a very good remedy; at any rate it would 
be lots of fun for the rest of the family and any 
visiting friends and neighbors. 



And now, in conclusion, what do we gather as 
to our conduct toward and treatment of this con- 
dition known as coryza^ or cold in the head ? First 



COLD IN THE HEAD. 12/ 

and best of all, let us become so strong and healthy 
that we cannot take cold, but this we cannot all 
of us do. Second, let us avoid the causes that 
lead to taking cold; this, too, is not always prac- 
ticable, and yet there are few of us who do not 
take more chances along this line than there is 
either need or reason for doing. Third, when we 
have taken cold, let us as quickly as may be possible 
break that cold completely: (i) By seeing that 
the bowels act properly. (2) By a hot foot bath 
with a hot drink and a resulting and unchecked 
sweat, taking in addition, about ten grains of 
Dover's powder with as much or more of quinine, 
and following all of this by a long night's rest. 
(3) And we shall do well to take small tonic doses 
of quinine three times a day for a week longer, 
and guard carefully against a fresh cold. 

That is how we may treat our cold when we 
are at home, but when we must use only those 
small medicines that we may carry with us we 
should (i) Take one or two C. C. pills. (2) Take 
some good make of coryza tablet, strictly accord- 
ing to the directions for that particular kind of 
tablet. (3) Take a small dose, say from two to 
six grains, of quinine, with the regular five or ten- 
grain dose of Dover's powder on going to bed, 
and follow this with small tonic doses of quinine 
for a week. 



128 COLDS, COUGHS AND SORE THROATS. 

And now this chapter is ended and we are willing 
to let Brother Coryza alone, if he will reciprocate 
and let us and our friends alone, which is a good 
promise, but a short one. 



CHAPTER VIII. 

SORE THROAT (Common Forms). 

Naso-Pharyngitis. Adenoids. Pharyngitis. 
Laryngitis. 

The throat includes all that part of the respiratory 
and digestive passages located behind the nose and 
mouth, and reaching to the oesophagus and larynx. 
This is the anatomical meaning of the word phar- 
ynx or throat, but in every-day language we also 
include the larynx, and the front of the external 
neck, while the naso-pharynx, or that part above 
the level of the mouth, is not included. In speak- 
ing of a sore throat the word is made to include 
also the tonsils and the soft palate which forms 
the dividing line between the mouth and the throat 
proper, and also the larynx; in short, all those 
parts and organs with which the air in ordinary 
respiration comes in contact between the nose and 
windpipe. 

Naso-Pharyngitis, The naso-pharynx includes 
all that part of the respiratory passages above the 
part of the throat visible from the front when the 
mouth is open, and lying behind the posterior open- 
ings of the nasal passages. Most of the naso- 

129 



130 COLDS, COUGHS AND SORE THROATS. 

pharynx is entirely above the mouth and is a com- 
pletely hidden portion of the respiratory passages. 
The nasal passages open directly into the naso- 
pharynx and at each side a little behind these open- 
ings the Eustachian tubes lead to the middle ear. 
These tubes regulate the air supply of this portion 
of the ear and prevent undue pressure on either side 
of the ear-drum. When closed, as often happens in 
coryza or naso-pharyngitis, various ear disturb- 
ances and sometimes diseases occur. Situated in 
the middle of the upper portion is the pharyngeal 
tonsil, which normally includes but a small amount 
of lymphoid tissue, but in adenoid hypertrophy, 
these tissues are enormously increased and altered 
in structure. Even in an ordinary cold or in naso- 
pharyngitis, there is much swelling and considerable 
secretion here. 

Naso-pharyngitis is an acute inflammation of this 
part of the throat and is almost invariably associ- 
ated with other inflammation in its immediate 
neighborhood. It is very frequently an extension 
of coryza, but it may follow or accompany an ordi- 
nary sore throat. In fact, so commonly is it associ- 
ated with coryza or pharyngitis that it is hardly 
considered a separate disease. Its causes are almost 
identical with those of coryza, the only symptom in 
which it markedly differs being the secretion of 
mucous in this region, which is gotten rid of by 
hawking or clearing the throat. The only necessary 



SORE THROAT (COMMON FORMS). I3I 

difference in treatment is that an effort must be 
made to make the sprays reach the naso-pharynx, 
instead of merely applying them to the nasal pas- 
sages. The sprays should be thrown far back into 
the nostrils and then drawn on down into the throat, 
passing over the parts involved. 

Adenoids, As already stated, the naso-pharynx 
forms the arching roof of the throat, lying above 
those portions that are visible when the mouth is 
widely opened. It is effectually hidden from in 
front by the tonsils and dependent parts of the soft 
palate, and can only be seen by the use of reflected 
light and laryngeal mirrors. Thus securely hidden 
from ordinary vision, it forms an ideal lurking 
place for that most baleful disease condition known 
as adenoid growths, the unsuspected proximity of 
which to vital processes affords it the fullest oppor- 
tunity to work out present misery and future in- 
capacity, or even death. In its milder forms it 
merely makes the victim markedly susceptible to 
colds and coughs, something of a mouth breather, 
and rather irritable and stupid. In fuller develop- 
ment it changes a naturally bright and lovable child 
into a dull, heavy and semi-imbecile dwarf, or it 
may extend the process even to the limits of ap- 
parent idiocy. In other cases the victim may be a 
peculiarly bright and active child, and the only out- 
ward symptoms are an apparently delicate consti- 
tution and a very marked susceptibility to colds, 



132 COLDS, COUGHS AND SORE THROATS. 

coughs and sore throats of almost every known 
variety. Normally there is a small amount of 
lymphoid tissue in this region, known as Luschka's 
tonsil, or the third, or pharyngeal tonsil, but in 
adenoid overgrowth it is enormously increased, 
usually taking on the form of fungoid vegetations, 
which crowd upon each other and attain such di- 
mensions that finally the nasal passages and Eusta- 
chian tubes may be completely closed. The condi- 
tion is most frequent in children from three to 
fifteen years of age, but it may be met with in adults 
or in mere babies. 

When these abnormal tissues are markedly de- 
veloped, physical growth is sometimes so seriously 
interfered with that the child is actually dwarfed. 
The face is stupid and expressionless, the mouth 
is constantly open, with snoring at night and rest- 
less, disturbed sleep, while, owing to the enforced 
mouth breathing, colds and coughs of all varieties 
are so easily acquired that the victim is rarely free 
from some complaint of this kind. The lips are 
thick, nose pinched, the voice disagreeably nasal, 
and the child is not only stunted in body, but in 
mind as well, becoming semi-imbecile or apparently 
idiotic. 

Taking all these things into consideration, it is 
easy to see how the mediaeval belief of fairy change- 
lings (a peevish, sickly goblin brat being substituted, 
in the mother's absence, for a healthy human child) 



SORE THROAT (COMMON FORMS). I33 

obtained ready credence in the days when witchcraft 
was an article of church behef and adenoids had 
not been heard of. The orthodox treatment in those 
days consisted in shaking the puny sufferer over a 
bed of red-hot coals in a sieve, in the behef that 
the gobhn would fly up the chimney with a horrible 
howl and in a burst of flame and smoke, while the 
human child would be restored. The howl was 
undoubtedly forthcoming under this treatment, but 
the rest of the program was much of a failure, 
and it remained for modern surgery to devise a 
more efiicient and rational method of restoring the 
normal child. 

When the adenoid condition is well developed, 
the symptoms are so marked and so numerous that 
they should infallibly lead to a suspicion of the 
true state of affairs, and examination by any good 
physician will make the diagnosis certain. There 
is but one proper treatment and that is surgical. 
While the operation looks severe, in competent 
hands the danger is slight, not to be compared with 
that which certainly exists as long as the condi- 
tion lasts. The natural and unavoidable repugnance 
to surgical procedures should therefore fade into 
insignificance in view of the undoubted results of 
neglect. To find a thoroughly competent surgeon 
is not always easy, but none other should be allowed 
to operate, and there are few sections of our coun- 
try where a moderate journey will not take one to 



134 COLDS^ COUGHS AND SORE THROATS. 

a hospital and the best of surgical skill. When 
the operation is well done, recovery is rapid and 
the real child is restored as if by magic. The dull, 
heavy features of the goblin brat fade and are 
replaced by those of the rightful owner, normal 
intelligence resumes its sway, and both physical and 
mental growth go on as if no such hideous inter- 
ruption had occurred. 

In those cases where an operation will not be 
tolerated, such tonics as codliver oil and the syrup 
of the iodide of iron should be administered, the 
child should be encouraged to take much out-of- 
doors exercise, diet should be plain but nutritious, 
and the throat, nose and mouth should always be 
kept most scrupulously clean. There is a natural 
tendency to partial or complete recovery at about 
fifteen years of age, as the respiratory cavities in- 
crease in size at this time, while the adenoid growths 
show a decided tendency to shrinkage. 

Pharyngitis. This is an acute inflammation of 
the mucous membranes of the pharynx. It usually 
includes all that part of the throat which can be 
seen when the mouth is widely opened, and in ad- 
dition there is more or less swelling of the tonsils 
and soft palate. This is probably the commonest 
and mildest form of sore throat, but it is often 
complicated by laryngitis or coryza, and may end 
in a severe attack of tonsillitis or other inflamma- 
tion. 



SORE THROAT (COMMON FORMS). 1 35 

Acute pharyngitis ordinarily lasts from three or 
four days to one or two weeks. 

The predisposing causes are lowered vitality, a 
rheumatic tendency, excessive use of alcohol, to- 
bacco or unduly rich foods, poor ventilation, mouth 
breathing and too much or too little clothing. 

The exciting causes are cold and damp air, get- 
ting the feet wet, a cold draft on the back of the 
neck or other sensitive part of the body, and irri- 
tating fumes and vapors. Sometimes it seems to 
be contagious or even epidemic. 

It may start with a distinct chill, but more often 
there are merely chilly sensations followed by slight 
fever and headache, and some degree of weakness. 
There is a feeling of dry discomfort in the throat, 
which later gives place to marked secretion, ac- 
companied with frequent cough. A sharp, pene- 
trating pain is felt, properly at the back of the 
throat, but often changing its location in a most 
puzzling manner. At one time this pain is on one 
side of the throat, in a short time it is on the other 
side, then lower down and at the back, and so on. 
There is a feeling as of a "lump" at the back of 
the throat, which causes constant but ineffectual 
efforts at swallowing and may interfere with real 
swallowing and the taking of food. The tonsils 
are often slightly inflamed and the uvula, or cen- 
tral dependent part of the soft palate, may be swol- 
len and very sensitive, causing a troublesome tick- 



136 COLDS^ COUGHS AND SORE THROATS. 

ling sensation, which gives rise to considerable 
coughing when lying down, especially at night. 

Treatment should be directed to the general sys- 
tem and directly to the inflamed throat. Unless the 
bowels are perfectly regular, take from one and 
a half to three grains of calomel, combined with 
twice as much soda, divided into six doses, a half 
hour apart, and two hours after the last dose take 
a heaping tablespoonful of Epsom salts dissolved 
in a cup of warm water. Or arrange to take the 
last dose of calomel at bed time and the salts the 
first thing in the morning. (See Chapter VI, 
"Medicinal Remedies.") A hot mustard foot bath 
may be taken at night with warm drinks and a 
dose of Dover's powders, and these measures are 
very likely to break up the attack. The next day, 
however, if not quite sure that it is checked, ten 
grains of salol may be given every three hours for 
three or four doses. 

A towel soaked in cold water and laid about the 
throat, renewed often enough to keep it continually 
cool, sometimes gives great relief. Bits of ice kept 
in the mouth will relieve some patients, but it is 
considered better to gargle frequently with water 
as hot as can be borne. When children are the 
sufferers a flannel bandage about the neck, soaked 
either in camphorated oil, or a mixture of one part 
of turpentine to three parts of olive oil, will be 
found useful. Lozenges of licorice, red gum or 



SORE THROAT (COMMON FORMS). I37 

slippery elm, ease the pain and divert the minds 
of the smaller sufferers, hence they are doubly 
useful. Lozenges of gum guaiac, each containing 
two to five grains of guaiac, may be obtained at 
the larger drug stores and will sometimes relieve 
a sore throat wonderfully. One lozenge is allowed 
to dissolve in the mouth three or four times daily. 

Laryngitis, This is an acute inflammation of 
the mucous membrane of the larynx. It ordinarily 
lasts about a week or ten days, but may hang on 
for two or three weeks and is frequently compli- 
cated with pharyngitis and coryza, or the inflamma- 
tion may extend downward and wind up with an 
attack of bronchitis. 

Predisposing causes are lowered vitality, any ob- 
struction to nasal respiration, sedentary life, poor 
ventilation and digestive disturbances. 

Exciting causes are getting the feet wet, cold 
drafts, especially on or about the neck (and it is 
claimed that those who are most careful to wrap 
the neck warmly in mufflers, or turn up the coat 
collar and button it tight on the slightest exposure 
are far more prone to this affection than others), 
too long continued or severe use of the voice, as 
in singing or public speaking, the inhalation of 
steam, smoke or irritating vapors, or the swallow- 
ing of too hot drinks, acids or other corrosives, 
and, as in all other respiratory diseases, some form 
of infective germ. The old fashioned Christmas 



138 COLDS, COUGHS AND SORE THROATS. 

or New Year's celebration, in which parties of 
young, middle-aged or even old men, went from 
place to place, drinking without much moderation 
and whooping and yelling like Commanches as they 
came from a warm room to the cold outside air, 
was a particularly effective mode of contracting a 
severe sore throat. Extension from coryza or bron- 
chitis is also a frequent source of laryngitis. 

The onset is sometimes with a distinct chill, 
oftener with chilliness, and there is fever, usually 
mild in type. Constipation is the rule and head- 
ache, pains in the limbs and general discomfort 
are common. The usual raw, dry feeling which 
ushers in any form of cold is felt in the throat, 
with a tickling irritation that induces a rough, harsh 
cough. The voice becomes husky and may be re- 
duced to a whisper or entirely lost. Owing to ex- 
tension of the inflammation downwards, soreness 
and pain are often felt in the median line under the 
breast bone. At first very little matter is coughed 
up, but in a day or two a sticky, white-of-egg like 
substance is brought up in considerable amount, 
becoming thicker and more cloudy in appearance 
as the disease progresses. 

In children the symptoms are sometimes of much 
greater severity and there is marked difficulty in 
breathing, with a hoarse, croupy cough, worse at 
night, and sometimes suffocative attacks that are 
very alarming to relatives. 



SORE THROAT (COMMON FORMS) . I39 

Treatment is commenced by a cathartic. A dose 
of salts may be given, but calomel with a little soda 
and followed by a dose of salts, or castor oil is 
preferable. If the hot mustard foot bath, warm 
drinks, quinine and Dover's powder are made 
use of on the first day of the attack, they are very 
likely to result in a quick cure, and if the succeeding 
day can be spent largely or entirely in doors there 
will be no ill results. If the trouble is not broken 
up at the start, the patient should, if possible, be 
kept in a room of uniform temperature, and the 
air should be kept moist by means of the croup 
kettle or an ordinary tea kettle on the stove. A 
tablespoonful of compound tincture of benzoin may 
be added to the boiling water every two or three 
hours with decided benefit. A towel, or other large, 
loose cloth, wrung out of water as hot as the pa- 
tient can bear, wrapped about the throat and fre- 
quently renewed so as to avoid cooling, is highly 
recommended. 

Turpentine, pure for a hearty, tough-skinned 
adult, but mixed with an equal amount of sweet oil 
for a thinner-skinned individual, well rubbed into 
the upper chest and neck until some redness is pro- 
duced, is an excellent counter-irritant and may be 
employed, either after, or in place of the hot, wet 
towel. For a child the mixture should consist of 
one part of turpentine to three or four of oil. The 
adrenalin solution, much weaker than used in 



140 COLDS, COUGHS AND SORE THROATS. 

coryza, say one part of adrenalin chloride to ten or 
fifteen of water, may be used once or twice daily 
with very good results if applied right. It is diffi- 
cult to direct a spray directly to the parts, and even 
if this is successfully done, they naturally close on 
the approach of anything of this nature, hence, it 
is necessary for the patient to breathe inward deeply 
while it is being applied, and it is better to use a 
nebulizer or an oil atomizer when attempting to 
reach those parts of the throat. The lozenges 
mentioned in treatment of pharyngitis, frequently 
also serve a good purpose in this form of sore 
throat. 

The different forms of cold and sore throat thus 
far considered are closely related, and the rules for 
diet apply to all alike. In the earlier stages the 
patients rarely have much appetite, which is nature's 
indication that, at this stage, little nutriment is 
needed. The patient should not be urged to eat, 
but when he displays any inclination to do so, he 
should be given small quantities of light and easily 
digested food. Milk is excellent, and to avoid 
monotony it may be prepared in various forms, as 
custards, boiled or baked, junket, whey, curds, etc. 
Buttermilk is highly recommended, and may be 
relished by some who do not care for fresh milk. 
Eggs, poached or lightly boiled, are very nourish- 
ing. When for any reason they cannot be taken 
in these ways, they will sometimes be tolerated if 



SORE THROAT (COMMON FORMS ) . I4I 

given in eggnog. Milk toast, gruels, broths, tapioca, 
sago, rice, arrowroot, and corn starch and gelatine 
preparations are all familiar foods for this condi- 
tion, and by selecting from among these a sufficient 
variety may be obtained. As soon as appetite re- 
turns, which will usually indicate that convalescence 
is established, the diet should be more nutritious 
than usual. The patient, .however, should exercise 
some caution at this stage, as the appetite often 
calls for more than the enfeebled system can as- 
similate. 



CHAPTER IX. 
SORE THROAT (Severe Forms). 
Diphtheria. Membranous Croup. 

Diphtheria, This is an acute, infectious, very- 
contagious and very dangerous disease. It affects 
children far more frequently than adults, but occurs 
at all ages, from extreme infancy to extreme old 
age. It is most common from the second to the 
fifteenth year and claims most victims between the 
ages of two and seven years. 

One particular variety of bacterium, the Klebs- 
Loffler bacillus, causes diphtheria. This bacillus 
effects a lodgment on and in the mucous membrane 
of the mouth, nose or throat, and causes the death 
of the membrane at the point of contact. Tissue 
elements and various liquid substances are thrown 
out from the blood vessels and other neighboring 
structures in an effort to destroy the germs and 
limit their ravages, coagulation of the fluids occurs, 
and bacteria, portions of the membrane, and cells 
from the surrounding tissues are bound together, 
forming the characteristic false membrane. In spite 
of this attempt at defense the bacteria multiply, the 
false membrane grows and spreads, and the bac- 

142 



SORE THROAT (SEVERE FORMS). I43 

teria in their growth and multiplication throw off 
poisonous substances (toxins) of great power and 
violence. These toxins, taken up by the blood and 
lymph currents, are carried to all parts of the body 
and by their harmful influence produce the great 
depression which characterizes this disease. The 
false membrane itself is dangerous only when it 
stops up some portion of the respiratory passages, 
usually the larynx, or when in its formation the 
walls of some blood vessel are involved and de- 
stroyed. The liberated poisons (toxins), however, 
are abundantly sufficient to cause death in very 
many cases. 

Lowered vitality is a predisposing cause of diph- 
theria, and diseased conditions of the mucous mem- 
branes of the mouth, nose and throat are especially 
favorable to the lodgment and development of the 
bacteria. Any scratch or wound in these mem- 
branes favors the reception and growth of the 
germs, and some authorities even claim that diph- 
theria cannot occur where the membranes are 
healthy and unbroken. 

Enlarged tonsils, adenoid hypertrophy or any 
inflammation of the membranes of mouth, nose or 
throat predispose, and this is one of the strongest 
reasons for promptly correcting any condition of 
this kind in children before they are subject to sucli 
contagion. When, however, diphtheria or any sim- 
ilar disease is known to be prevalent, no operative 



144 COLDS, COUGHS AND SORE THROATS. 

procedure should be attempted, as the wounded 
surfaces would invite contagion. Decaying and 
unclean teeth induce inflammation in the adjacent 
mucous membranes, and for this reason, while the 
mouth should at all times be kept clean and whole- 
some, it is doubly necessary when such diseases as 
diphtheria prevail. 

In every case of diphtheria there has been ex- 
posure to the contagion, even though the infected 
article may have received the contagion months 
before and at a distance of hundreds of miles. 
Sometimes diphtheria develops when no exposure 
can be remembered or discovered, as when it comes 
from some toy, garment, book or utensil, packed 
away for months, or obtained from some store, 
perhaps in what are called ''rummage sales," where 
all sorts of second-hand articles, partially worn 
clothes and other articles of questionable cleanliness 
are sold. In other cases some individual, perfectly 
healthy himself, carries the deadly germs harmlessly 
for months in his own respiratory passages, but 
is nevertheless capable of imparting the contagion 
and starting a fatal case of diphtheria in some other 
person. 

Three forms of diphtheria are commonly de- 
scribed, the pharyngeal or tonsillar, the laryngeal 
and the nasal. The most noticeable difference is 
in the location of the false membrane, but other 
important differences exist and call for some varia- 
tion in treatment. 



SORE THROAT (SEVERE FORMS). I45 

Pharyngeal, or Tonsillar Form, In this form of 
diphtheria, the symptoms develop in from two to 
seven days after exposure to the contagion, though 
in a very few cases the period may be two or three 
days longer. Usually in a child there is listless- 
ness and dullness; he does not care to play, com- 
plains of feeling tired, is chilly and has a mild 
headache, and there may be pains in the back and 
limbs. In younger children convulsions sometimes 
occur. There is fever, but it is not high, and the 
throat is sore, but not more so than in ordinary 
sore throat or pharyngitis. In a short time the 
membrane begins to form. At first there may be 
a single small spot, mouse-colored, grayish-white 
or yellowish, with a marked tendency to spread. 
It usually appears first on one tonsil, but may ap- 
pear on both tonsils simultaneously, or on the back 
of the throat, or on the soft palate, and in a few 
days it may involve all of these structures. Fre- 
quently the mucous membrane at the margins of 
the false membrane shows a peculiar purplish or 
maroon tint. The rest of the throat is red and 
inflamed and often much swollen, the glands under 
the angles of the jaw on one or both sides become 
enlarged, hard and painful, and the tonsils swell 
in greater or less degree. In the meantime the 
child becomes decidedly sick. The fever in mild 
cases is not very high, about loi to 102 degrees, 
but depression and dullness are marked, appetite 



146 COLDS, COUGHS AND SORE THROATS. 

fails and the pulse is rapid and feeble. If the case 
ends favorably, in about a week the symptoms im- 
prove and the false membrane separates and is 
thrown off, leaving an inflamed, red surface. Re- 
covery is slow and not complete for many weeks, 
and even mild cases leave the patient very susceptible 
to other diseases, while paralysis or other alarming 
sequelae may develop a week or two after apparent 
recovery commences. 

In the severest form, the symptoms are greatly 
intensified. For a day or two the course is much 
like that of the milder cases, and then the condi- 
tion suddenly becomes alarming. The temperature 
reaches 103 or 104, vomiting may be severe, the 
glands at the angles of the jaw swell rapidly, form- 
ing hard, painful masses, the throat is greatly 
swollen in all its parts, and the false membrane 
is extensive, ragged, and has a strong tendency to 
slough, or fall away from the adjacent tissues. The 
pulse is very feeble and rapid, the face, neck and 
chest become puffy and dropsical, and death may 
occur in two or three days or within one or two 
weeks. 

In the tonsillar or pharyngeal form of diphtheria 
the chief danger lies in the action of the poisons 
set free by the bacteria, but it is always possible 
for the membrane to extend downward and involve 
the larynx, in which case the added danger of 
suffocation, the great characteristic of laryngeal 
diphtheria, must be contended with. 



SORE THROAT (SEVERE FORMS). I47 

Laryngeal Form. In the laryngeal form the 
preliminary symptoms are like those of the pharyn- 
geal type already considered, but the false mem- 
brane is formed directly in the larynx and mechani- 
cally closes the narrow chink of the glottis, causing 
death by interference with respiration. This is the 
form in which intubation or tracheotomy sometimes 
becomes necessary. The danger of suffocation is 
the characteristic feature of this form of diphtheria, 
but even when this is overcome the poisoning of 
the entire system still gives a serious condition to 
deal with. In its tendency to cause death by sudden 
suffocation this disease resembles non-diphtheritic 
membranous croup, with which it is often con- 
founded, and which will be more fully considered 
later. 

Nasal Diphtheria is that form in which the false 
membrane is formed in the nasal cavities. There 
IS a mild form in which the principal symptom is 
obstruction of the nostrils, and yet according to the 
bacteriological test it is genuine diphtheria. In this 
mild form the disease is only feebly contagious, 
and there are no marked general symptoms. Too 
frequently, however, it assumes a more serious 
character and becomes extremely dangerous. The 
lymphatics and blood vessels about the nasal cavities 
are very numerous and active, and in the severe 
form of nasal disease the poisonous substances 
formed by the bacteria are taken up by these vessels, 



148 COLDS, COUGHS AND SORE THROATS. 

and in the blood and lymph streams are carried 
to all parts of the body, so that the victim is quickly 
overwhelmed with these violent poisons. The 
glands at the angles of the jaw are swollen to a 
great degree, stonily hard and extremely painful 
and the general symptoms are very severe, quickly 
reaching a climax marked by the death of the 
patient. 

Treatment, Diphtheria is in no way, shape nor 
manner a disease for home treatment. If a good 
doctor can be obtained, send for him at once and 
let him take complete charge of the case, carrying 
out his instructions to the minutest particular and 
seconding his endeavors in every possible way. 
Antitoxin has revolutionized the treatment of diph- 
theria, but to secure its fullest benefit it should be 
administered very early in the course of the disease, 
so the sooner the doctor arrives the better the chance 
for a favorable termination. If a good doctor can 
not be obtained, then and then only, home treat- 
ment must suffice, and should be administered as 
energetically and intelligently as circumstances ren- 
der possible. 

As all of the patient's vigor is needed to contend 
with the overwhelming depression which character- 
izes this disease, a very important part of the treat- 
ment is to keep up his strength and vitality. At 
one and the same time he must be guarded against 
exhausting what strength he has, and must be given 



SORE THROAT (SEVERE FORMS). I49 

such nourishment and other treatment as will tend 
to increase his vital forces. To secure the first end 
the patient should be kept strictly in bed, not leav- 
ing it for any purpose. All fussing and worrying 
are injurious. On this account the character of 
the nurse is of much importance. She should not 
only be calm and of an even temperament herself, 
but capable of soothing the patient when he be- 
comes restless or nervous. For the same reason, 
as well as to limit the possibilities of contagion, 
no one but the nurse must be allowed in the room, 
and excitement of every kind must be avoided. 

The sick room should be bright and sunny, but 
may be darkened when the patient is restless or 
when darkness will aid in restfulness or sleep. The 
room should be well ventilated, but drafts are not 
to be tolerated. The temperature should be that 
which is most comfortable to the patient, ordinarily 
from 68 to ^2 degrees. A sponge bath, carefully 
given, with the water at blood-heat, will add ma- 
terially to the comfort of the patient and should be 
made use of daily. Even twice a day does good 
in many cases. 

Owing to the condition of the throat, foods are 
necessarily liquid, or semi-liquid, but should be as 
nourishing as possible. Milk, buttermilk, concen- 
trated broths, and eggs, raw or so slightly cooked 
as to be easily swallowed, are all suitable for this 
disease. Food should be given at regular intervals. 



150 COLDS, COUGHS AND SORE THROATS. 

more frequently than in health but in smaller quan- 
tities, and when the patient is lethargic and dull, 
it is often necessary to insist on his taking nourish- 
ment at the proper times. 

Alcoholic liquors are very highly recommended 
in diphtheria, their usefulness being greater in pro- 
portion to the weakness of the patient and the 
strength of the disease. Two tablespoonfuls of 
good whiskey in twenty-four hours, well diluted, 
for a child of four years, is a good average for 
mild cases ; in the severest form eight or ten times 
as much is not only justifiable but advisable. For 
an older child the amount should be proportionately 
larger. In fact, in this disease, the only limit to 
the use of liquor is the ability of the patient to take 
it without symptoms of disgust or nausea. As few 
of these smaller patients are fond of liquor diluted 
only with water, it is well when it is necessary to 
give these large amounts to administer it in other 
articles of food, as in the form of milk punch or 
eggnog. 

At the very beginning of the disease, calomel 
should be given in quarter-grain tablet triturates, 
one every half hour until the bowels are thoroughly 
moved. 

Tincture of the chloride of iron is a tonic remedy 
of great value. An excellent combination is one 
part of the tincture to four parts of glycerin, of 
which mixture fifteen drops in water are to be given 



SORE THROAT (SEVERE FORMS). I5I 

to a child of one year every two hours, and thirty 
drops to a child over two years old. No food or 
liquid of any kind must be given after this medicine 
for at least ten or fifteen minutes, as the tincture 
of iron exercises a highly beneficial local effect on 
the diseased throat through its astringent and tonic 
properties. In very severe cases where alcoholic 
stimulants are used in large quantities the iron tonic 
must be omitted, as the digestive organs cannot 
assimilate both, and in these desperate cases the 
alcohol is more necessary and useful. 

The tonic treatment, both iron mixture and alco- 
hol, should be continued until convalescence is well 
established. The doses, however, may be gradually 
diminished, and especially is this true of the alco- 
holic stimulant when it has been used in the enor- 
mous amounts required in a highly dangerous case. 
In any form of diphtheria the swollen glands and 
neck may cause much pain and discomfort. In older 
children the application of an ice bag or of cloths 
wrung out of very cold water will sometimes give 
great relief. In younger children the swollen sur- 
faces may be gently rubbed with warm camphorated 
oil. Plain olive or cottonseed oil will also serve a 
useful purpose in this way, or cloths wrung out of 
hot water and often changed may be used. 

In any form of diphtheria the air of the sick 
room may be kept moist by dropping large pieces 
of unslaked lime in a tub or large pail of water. 



152 COLDS, COUGHS AND SORE THROATS. 

sufficiently often to keep the air fairly full of the 
limy vapor. This is peculiarly beneficial whenever 
there is danger of the laryngeal form developing. 

In the tonsillar or pharyngeal form the throat 
may be swabbed, sprayed or gargled with hydrogen 
peroxide, full strength if it can be tolerated, or 
mixed with an equal quantity of water. This pro- 
cess may need to be repeated every hour in severe 
cases, but ordinarily two or three times a day is 
sufficient. Care must be taken that the healthy 
membrane is not injured in this process, and where 
the child struggles much and the false membrane is 
not spreading rapidly it may have to be omitted. 
A mother of two children lost one by diphtheria. 
More fearful of this scourge than of a lurking tiger 
(and remembering the difficulty in administering 
proper medication) she taught the remaining boy 
to take medicine and use throat washes by seeing 
which could swallow the most bread pills and which 
could gargle most thoroughly and protractedly with 
warm water. In process of time the child so taught 
was attacked by diphtheria and the attending phy- 
sician (this was before the days of antitoxin) ex- 
pressed surprise at the facility with which the little 
patient used the gargles, declaring that this fact 
probably saved his life. 

In all operations or procedures about the nose 
or throat of a diphtheria patient, great care must be 
taken that no particles from the diseased structures 



SORE THROAT (SEVERE FORMS). I53 

lodge in the face of the nurse, and the hands should 
always be disinfected after each manipulation. 

In the laryngeal form of diphtheria, or when 
the membrane extends to the larynx from a case 
originally of the pharyngeal type, a bronchitis tent 
should be hastily constructed over the bed, steam 
supplied from a bronchitis kettle, or from an ordi- 
nary tea kettle, to the spout of which rubber tubing 
may be connected and led into the tent, and ten 
grains of calomel should be placed in a metal spoon 
and held over the flame of a candle in the tent 
until the calomel is completely vaporized. An 
abundance of steam should be supplied until all 
danger of suffocation is past, and the vaporization 
of a similar quantity of calomel should be repeated 
every three or four hours imtil breathing is easy and 
natural. 

If these measures do not quickly relieve the diffi- 
culty in breathing, an emetic may be necessary and 
there should be no hesitancy in making use of it. 
The yellow subsulphate of mercury, often known 
as "turpeth mineral," is highly recommended in 
this emergency. It is a quickly acting emetic and 
it is claimed that it does not produce depression, 
a peculiarity which renders it especially valuable in 
diphtheria. The dose for a two-year-old child is 
two to three grains, repeated in fifteen minutes if it 
does not act in that time. More than two doses 
should never be administered, and if vomiting is 



154 COLDS, COUGHS AND SORE THROATS. 

not produced in ten or fifteen minutes after the 
second dose, use some other emetic at once. Mus- 
tard flour mixed with warm water, two tablespoon- 
fuls to a glass of warm water, makes a safe and 
prompt emetic that will rarely fail. If the turpeth 
mineral is not at hand mustard probably will be, 
and the old familiar scheme of tickling the back of 
the throat with a feather may be used if mustard 
or other household emetic is lacking. The vomiting 
usually causes the expulsion of the false membrane 
and reopens the larynx. 

In the nasal form of diphtheria, or when the 
membrane reaches the nose by extension from the 
throat, the nasal passages are largely occluded, 
frequently completely blocked, compelling mouth 
breathing, and quickly producing symptoms of toxic 
absorption. The general treatment is similar to 
that of the other forms, but the local obstruction 
calls for persistent irrigation of the nasal passages 
in order to keep the false membrane washed away 
and prevent, or largely check, the formation and 
absorption of the poisonous substances. An ordi- 
nary fountain syringe can be used to good effect 
for this purpose. It should be provided with a 
nozzle of hard rubber large enough to fit the nostril 
closely and should be so held that the stream flows 
directly backward toward the throat; if directed 
upward so that the stream flows towards the top of 
the head it fails, largely or entirely, of the desired 



SORE THROAT (SEVERE FORMS). 1 55 

effect. A teaspoonful of fine table salt dissolved 
in a quart of warm water makes a suitable irrigating 
fluid, and for use should be fairly warm — no to 
115 degrees is recommended. The water bag should 
be held from one to five feet above the nostrils, 
according to the amount of pressure required to 
wash out the membrane, and the stream should 
return through the other nostril. After successfully 
clearing one nostril, insert the nozzle in the other 
nostril and repeat the process. In severe cases the 
nostrils may have to be washed out in this way 
every hour for several days; in milder cases once 
in twelve hours is often sufficient. In case of a 
young child who does not understand and will not 
submit, the entire body, arms and legs may be 
wrapped in a blanket, thus preventing struggling, 
and the irrigation may be made with the child lying 
on its side, a rubber blanket being so spread as to 
convey the fluid to a vessel on the floor. 

Convalescence is protracted and various after 
effects may occur. Sudden heart failure, broncho- 
pneumonia and paralysis, more or less sudden, are 
numbered among them. There is always weakness 
and anemia, so that in severe cases the patient 
should be kept in bed several weeks after the most 
serious symptoms have moderated, and careful 
nursing and feeding will have to be continued until 
the patient is manifestly stronger and prepared once 
more to take an active interest in life and his sur- 



156 COLDS^ COUGHS AND SORE THROATS. 

roundings. Very little exertion should be allowed 
on the part of the patient for several weeks after 
convalescence is surely established, as sudden heart 
failure sometimes occurs on very slight apparent 
cause even a week or two after the change for the 
better. 

Diphtheria is a disease in which too much care 
cannot be exercised, both as regards the patient 
himself and the danger of contagion to other par- 
ties, and the rules for prevention of contagion, as 
laid down in Chapter IV, should be most carefully 
observed. 

Remember that throughout the disease every care 
must be taken to prevent needless exertion on the 
part of the patient and to add to his sorely tried 
strength by the most nourishing food, the kindliest 
nursing and the most watchful care. 

Membranous Croup. This disease is so closely 
related to laryngeal diphtheria that the possibility 
of a non-diphtheritic croup was for a long time 
denied by many most excellent physicians. When 
non-diphtheritic it is caused by some other organ- 
ism, most commonly the streptococcus pyogenes, 
but a false membrane is formed in the larynx ex- 
actly as in laryngeal diphtheria, differing from the 
diphtheritic membrane in not being so closely ad- 
herent to the structures on which it is formed. The 
disease also differs from the diphtheritic type in its 
sudden onset and in not being contagious. 



SORE THROAT (SEVERE FORMS). I57 

Membranous croup is most common in children, 
though adults are sometimes attacked, and it de- 
stroys life by suffocation. The child is usually in 
fair health or but mildly sick. Towards evening 
a harsh, brassy cough is heard, which is usually 
the first intimation of danger. During the night 
the little patient wakes in imminent danger of stran- 
gulation, the "croupy'' cough is very marked, the 
breathing loud and stridulous, and the attempts to 
secure sufficient air are pitiful and violent. If not 
quickly relieved, lips and fingers become bluish, the 
face livid, respiration gradually becomes slower and 
the child falls into a state of stupor ending in death. 

This is a disease in which quick action is neces- 
sary in order to save life. 

The treatment is the same as that for an acute 
attack of laryngeal diphtheria. A bronchitis tent is 
constructed over the bed and filled with steam, calo- 
mel is vaporized every two or three hours, and if 
strangulation seems imminent an emetic must be 
administered. If there is any trouble in forming 
the tent, or while constructing it, the air of the 
room may be moistened by boiling water in a tea 
kettle over an alcohol lamp, stove or any other 
means at hand, or by dropping unslaked lime in 
a tub or large pail of water, which will keep the 
entire room full of limy vapor, which it is claimed 
is particularly beneficial in these croupy cases, both 
diphtheritic and non-diphtheritic. When the bron- 



158 COLDS, COUGHS AND SORE THROATS. 

chitis tent is used care must be taken that sufficient 
air mingles with the steam, and for this purpose 
one side of the tent may be left open or the side 
withdrawn sufficiently often to supply a proper 
amount of air. 



CHAPTER X. 

SORE THROAT (Severe Forms). 

Tonsillitis. 

Tonsillitis. This disease is an acute inflammation 
of the tonsils and pharynx. The tonsils are also 
called amygdalae, from amygdala, an almond, and 
from this we get the term amygdalitis, synonymous 
with tonsillitis. 

In tonsillitis the substance, as well as the mucous 
membranes of the tonsils, is involved, and they 
sometimes swell to two or three times their ordi- 
nary size. Indeed, they may meet and press against 
each other in the middle line, interfering with 
breathing and making it impossible to swallow. 
The pharynx, or back of the throat, is also con- 
gested and inflamed, so that the discomfort of an 
ordinary sore throat is added to that caused by the 
tonsils themselves, and the soft palate, particularly 
the uvula or middle dependent portion thereof, par- 
ticipates in the general inflammation and adds a 
third factor of unrest. 

There are two forms of acute tonsillitis. In 
follicular or lacunar tonsillitis the mucous mem- 
branes and the parts lying under and close to it 

159 



l6o COLDS, COUGHS AND SORE THROATS. 

are principally involved. In the suppurative form, 
also called true tonsillitis and quinsy, either the 
substance of the tonsil itself, or the loose tissues 
surrounding it are inflamed and pus formation 
occurs. This form usually terminates by the pus 
breaking through the tissues and discharging into 
the mouth and throat, just as a boil discharges on 
an external surface. 

In either form, though more commonly in the 
follicular variety, an exudate may form on the sur- 
face of the tonsil, so closely resembling the false 
membrane of diphtheria that this more deadly rela- 
tive is often suspected, and in this case it is the 
part of wisdom to consider it as diphtheria until 
satisfied to the contrary. 

Predisposing causes are lowered vitality, the 
rheumatic tendency, damp or poorly ventilated liv- 
ing or working rooms, mental worry and general 
depression. The exciting causes are getting damp 
or otherwise chilled, getting the feet wet, drafts of 
cold air, especially on the neck or side of the face, 
indigestion and constipation, vitiated air, or the 
inhalation of smoke or vapors. The follicular form 
is considered mildly contagious, and both varieties 
are believed to depend on bacterial activity. 

Follicular tonsillitis usually begins with a chill 
or chilly sensations, with fever quickly reaching 
103 or even 105 degrees. Sometimes the onset is 
with aches and pains in all the muscles, growing 



SORE THROAT (SEVERE FORMS). l6l 

more and more severe until the victim is sore all 
over and feels as if he has been run through a thresh- 
ing machine. At other times it begins as an ordi- 
nary pharyngitis, the symptoms at first being those 
of a severe sore throat. Headache is often severe, 
the tongue is coated and the breath foul, while 
swallowing is painful or impossible. The voice is 
hoarse and the neck stiff and moved with diffi- 
culty. Constipation is the rule, and the urine 
is scanty and high colored. The fever and severe 
general symptoms last three or four days, but if 
one tonsil is first attacked and as it returns to nor- 
mal, the other tonsil takes up the process, the symp- 
toms are correspondingly lengthened. The tonsils 
usually show spots or patches of exudate, white 
or yellowish in color, and not infrequently these 
run together and cover the tonsil, giving rise to a 
suspicion of diphtheria. 

In quinsy, or suppurative tonsillitis, there is much 
more pain in the immediate neighborhood of the 
affected tonsil, and the glands of the neck and under 
the jaw swell more markedly, but in this form 
the general symptoms are less severe. There is 
keen pain radiating toward the ear, and the stiff 
and painful neck is more markedly in evidence. 
Swallowing is frequently so painful as to prevent 
eating. Pus gradually forms and in four or five 
days breaks through the tissues, when it is either 
swallowed or ejected. After this the symptoms 



l62 COLDS, COUGHS AND SORE THROATS. 

abate and the patient usually makes a good re- 
covery. 

Tonsillitis is a disease that well justifies the pres- 
ence of the doctor. The milder attacks may do well 
under home treatment, but a severe case calls for 
all the relief that medicine can give. The suppura- 
tive form should have the relief of lancing, and if 
there is even a suspicion of diphtheria, medical 
intervention is imperative. 

Diphtheria comes on slowly and is usually pre- 
ceded by dullness and depression but no chill. Ton- 
sillitis is sharp and sudden in its attack, very com- 
monly there is a chill, and the fever is usually 
higher. Probably, however, the greatest distinction 
is in the false membrane. That of diphtheria is a 
dirty grayish or grayish yellow color, is tough and 
adherent, can only be removed by forceps or other 
violent means, and leaves a bleeding surface on 
which the membrane quickly forms again. That of 
tonsillitis is not a real membrane at all, is usually 
whitish or yellow, can be easily removed by a bit 
of cloth or a little cotton wound on an applicator 
or small stick, and leaves a smooth, red, swollen 
surface, without any bleeding. In some cases, how- 
ever, these points vary, and it is only by bacterial 
cultures, or by the use of a microscope, that the 
true nature of the disease can be surely determined. 

At the very commencement of any form of sore 
throat it is a good plan to try to check it by the 



SORE THROAT (SEVERE FORMS). 163 

use of antiseptic sprays or gargles. Listerine, di- 
luted with two or three times its volume of water, 
makes a safe, pleasant and efficient spray. Hydro- 
gen dioxide, pure or diluted with an equal volume 
of water, is probably one of the best, but when 
employed as a spray must be used with a glass- 
tipped spray tube, as it destroys the ordinary rubber 
tubing and tips. A heaping teaspoonful of soda in 
a glass of water also makes a good spray fluid or 
gargle. 

After the disease is fully developed, these appli- 
cations still serve a good purpose in cleansing the 
throat, and should be continued for that purpose. 
Either sodium salicylate or common baking soda, 
rubbed on the tonsils with the finger, gives some re- 
lief and is distinctly beneficial. As in other colds, 
overcome constipation promptly with calomel and 
salts and keep the bowels free while the disease lasts. 
Rochelle salts and common baking soda, mixed in 
equal parts, should be given three times a day, a 
teaspoonful at each dose. This aids in keeping the 
bowels open, overcomes the acidity of the urine 
and helps all around. Sodium salicylate is con- 
sidered almost a specific (a sure cure) for those 
cases with a marked rheumatic tendency, and should 
be given in the dose of ten to fifteen grains, every 
two hours for ten or twelve doses. 

Guaiac lozenges, each containing two or three 
grains of the guaiac resin, may be obtained at any 



164 COLDS^ COUGHS AND SORE THROATS. 

large drug store, and one of these allowed to dis- 
solve in the mouth once in two or three hours 
will give great relief. Some people, however, do 
not tolerate this drug and should rather use sodium 
salicylate. In the follicular form of tonsillitis an 
ice bag (a small rubber bag, or a sheep's or pig's 
bladder, filled with pounded ice and securely fasten- 
ed) should be kept over the angle of the jaw, as 
nearly as may be, covering the affected tonsil. A 
towel should be laid between the ice bag and skin 
to avoid too great cold and to absorb moisture. In 
suppurative tonsillitis hot compresses usually give 
great relief. They may be improvised by wringing 
large towels or other cloths out of water as hot as 
can be borne, and should be frequently changed be- 
fore they cool. Sometimes bits of ice, held in the 
mouth, seem to do good; in other cases gargling' 
the throat with water as hot as can be borne gives 
the greatest relief. 

In the suppurative form, lancing the abscess as 
soon as it points, shortens and lessens the pain most 
markedly, but this should only be attempted by some 
one who understands it, and naturally this falls to 
the doctor. When lancing is not resorted to it 
usually breaks of its own accord a little later, and 
recovery is the rule. 

During the severity of the attack, the intense pain 
of swallowing makes liquid food a necessity. Cold 
milk is the commonest bill of fare and ice cream is 



SORE THROAT (SEVERE FORMS). 165 

claimed to be a safe and pleasant food. Custards 
and soft boiled or poached eggs are sometimes well 
taken, and as recovery advances the diet should be 
nutritious and tonics should be used. The ordinary 
diet may be gradually resumed. 

In all forms of sore throat it is well to use the 
gargles or sprays referred to in this chapter, and 
they are most effective when used as soon as symp- 
toms are felt. If this course is followed, many sore 
throats which might develop into serious diseases 
may be checked in their incipiency. If, however, 
they persist, the cathartic and hot foot bath should 
be made use of, and if these do not end the trouble, 
the treatment appropriate for whatever form of cold, 
cough or sore throat develops should be applied.. 



CHAPTER XI. 

COUGH (Cold on the Chest). 

Bronchitis. 

As coryza is our common cold, so is bronchitis, 
tracheo-bronchitis, or, as some of the good old 
ladies call it, ''brown skeeters," our common cough. 
Bronchitis itself signifies an inflammation of the 
bronchi, which are the divisions of the windpipe 
leading to the lungs. Tracheo is prefixed to bron- 
chitis, giving the term tracheo-bronchitis, because 
the trachea, which is the windpipe, is almost in- 
variably and unavoidably a partaker in the inflam- 
mation. The disease is also called cold on the chest 
because of the rawness and soreness in and on the 
chest. 

The definition of bronchitis is an ''acute catarrhal 
inflammation of the mucous membranes of the 
trachea and bronchi." Acute indicates that it comes 
on with some degree of suddenness, catarrhal, that 
there is increased secretion, and inflammation de- 
scribes the feverish, swollen and congested condition 
of the afifected membranes. 

The tissues involved in bronchitis are parts of 
what is frequently spoken of as the respiratory 

i66 



BRONCHITIS. 167 

tree. Now, in order that we may get an approxi- 
mate idea of where these tissues He, let us do a little 
supposing, and instead of trachea we will say trunk, 
and instead of bronchi we will say branches. Sup- 
pose, then, that we have a stout, stubby little tree, 
the trunk about an inch in diameter at the base and 
extending without branches from three and a half 
to four and a half inches high. Here, however, it 
divides into two main branches, each of which 
rapidly divides and subdivides until the finest twigs 
terminate, each in a little bunch of somewhat cherry- 
like, but microscopically small fruit (the alveoli 
or air cells of the lungs). Further, suppose that 
every part, trunk, branches, twigs and fruit, is 
hollow, and that this hollow little animal tree is 
turned upside down and set in the throat and chest, 
the trunk joined to the larynx. (The larynx is 
easily located in the throat, its upper edge forming 
the most prominent external part, the Adam's ap- 
ple.) Behind the breast bone and about an inch 
lower than the notch which marks its top the trachea 
divides into two branches, one extending to the 
right, the other to the left. These are the right and 
left bronchi and divide and subdivide until the 
finest twigs (capillary bronchioles) penetrate every 
part of the lung structure and terminate in the hol- 
low fruit, the walls of which are so fine and thin 
that the waste matters brought to their outer sur- 
faces by the blood are easily exchanged through 



l68 COLDS^ COUGHS AND SORE THROATS. 

these delicate membranes for the life-giving oxygen 
brought to their inner surfaces in the air we breathe. 

The mucous membranes of the trachea and bron- 
chi (the trunk and larger branches of our respira- 
tory tree) are the parts involved in bronchitis. The 
predisposing causes of bronchitis are much the same 
as those of coryza.^ Lowered vitality is the prin- 
cipal predisposing cause, and this is greatly favored 
by the pampering we give our precious selves. 
Overheating of offices and living rooms, wearing 
too many and too heavy clothes, especially too much 
muffling of the neck and throat, and the use of 
chest protectors all predispose. Careless eating and 
digestive disorders aid in the bad work, while lack 
of exercise adds the finishing touch and leaves the 
whole physical system out of tune. Heart and kid- 
ney diseases weaken and interfere with the circula- 
tion, hence are effective predisposing causes. Also, 
many of the acute diseases affecting the respiratory 
organs, such as la grippe, measles, whooping cough 
and the pneumonias, predispose so strongly that 
bronchitis is always to be guarded against in their 
later stages. 

Coryza, or cold in the head, is a very effective 
exciting cause of bronchitis, either by extension of 
the inflammation to the throat and so on down to 
the trachea and bronchi, or by inducing mouth 
breathing, which supplies colder, drier and less pure 
air than that which has been properly drawn through 



BRONCHITIS. 169 

the warming, moistening, and dust and microbe 
retaining nasal cavities. From an ordinary sore 
throat (pharyngitis or laryngitis), the inflammation 
may readily extend downward and give rise to 
bronchitis. 

The other primary exciting causes are much like 
those of other colds and coughs. Cold and damp- 
ness, especially when accompanied by searching 
winds, and sudden and marked changes of temper- 
ature, are among the commoner exciting causes, 
and as these are characteristic of the late winter 
and early spring, so is bronchitis prevalent at these 
seasons. -(irritant vapors and gases, dust laden air, 
heavy fog, and even a superabundance of tobacco 
smoke, or smoking, may furnish a satisfactory 
starting point.^ 

But at this point an auxiliary set of exciting 
causes make their appearance, in the shape of a host 
of microbes, variegated as to kind and names. 
Certain of the severer respiratory diseases, as in- 
fluenza, diphtheria, and whooping cough, are each 
due to a specific organism ; that is, to one especial 
kind of bacterium whose activity always results in 
the one special disease and nothing else, but bron- 
chitis and probably its forerunners, coryza, pharyn- 
gitis and laryngitis, rejoice in the proud distinction 
of being polymicrobic; that is, any one of them 
may be caused by any one or more varieties of a 
whole raft of the skulking little reprobates, the dis- 



170 COLDS, COUGHS AND SORE THROATS. 

ease depending on the location rather than on the 
organism that aids in the inflammation. 

In vigorous patients, from youth up to the Hmits 
of middle age, bronchitis usually lasts two or three 
weeks and is not of itself a dangerous disease. Very 
frequently it follows coryza or a sore throat, but it 
sometimes starts as an independent disease. In 
this case there may be a day or two of lassitude, 
or ''feeling mean," or it may begin with a chill, 
or chilliness, and fever, ordinarily slight, but some- 
times running up to 103 or 104 degrees. The first, 
or dry stage, lasts from a day to two or three days, 
during which nothing is coughed up. There is a 
cough, however, rough, irritating and sometimes 
very severe. Often there are paroxysms of cough- 
ing which strain the muscles and rack the entire 
chest so that even the external surface is tender and 
painful to the touch, and there may be lines of 
tenderness corresponding to the course of the bron- 
chi and their larger branches. There is a raw, 
tearing soreness in the middle and upper part of 
the chest under the breast-bone, and a feeling of 
tightness and constriction across the outer surface. 

Following this is the stage of secretion. The 
cough becomes looser, the pain, tenderness and 
constriction are less, and matter is coughed up, 
at first scanty, viscid, almost transparent, or frothy, 
and sometimes slightly streaked with blood, owing 
to rupture of small blood vessels in the congested 



BRONCHITIS. 171 

mucous membranes under the strain of coughing. 
In a day or two the coughed-up matter becomes 
much freer and more abundant, of a yellowish, or 
greenish yellow color, much thicker and more tena- 
cious. The coughing gradually becomes less fre- 
quent and less severe, the other symptoms moderate, 
and in from a week to two or three weeks the 
patient is practically over the attack, although some 
degree of cough and expectoration may last for 
several weeks longer. 

In these vigorous patients, bronchitis may be 
broken up at the very beginning, exactly as a cold 
in the head may, by a laxative, if needed (and it 
almost always is), the hot mustard foot bath, with 
warm drinks, quinine and Dover's powder, and an 
unchecked sweat. In addition the chest may be 
well rubbed with camphor liniment, camphorated 
oil, or what is perhaps better, with turpentine and 
sweet oil, half or two-thirds of the mixture being 
turpentine for a hearty adult, but one part of tur- 
pentine to three or four of the olive oil for a child. 

If on the morning following these measures, the 
cough, soreness and other symptoms are not broken 
up and abolished, other remedies must be used. For 
the dry, irritative cough, mix one fluid ounce (two 
tablespoonfuls) of syrup of ipecac, one-half fluid 
ounce (one tablespoonful) of sweet spirits of niter 
and an ounce and a half (three tablespoonfuls) of 
water, making three ounces of the mixture. Two 



172 COLDS, COUGHS AND SORE THROATS. 

teaspoonfuls of this mixture should be given every 
four hours until the cough becomes loose. Inhala- 
tions of steam are very useful at this stage. For 
this purpose from a pint to a quart of boiling water 
should be put into a pitcher, and from a teaspoon- 
ful to a tablespoonful of the compound tincture of 
benzoin added. The patient should bend over the 
pitcher, and a towel be laid over his head, covering 
it and the pitcher. Care must be taken that the 
steam does not scald, especially if the patient be a 
child. He should remain under this improvised 
cover, breathing the rising vapor, for about ten 
minutes. This process may be repeated frequently, 
even hourly if the patient seems to need it, but 
when taking it he must be careful not to expose 
himself in any way, as by going out of doors or 
into an unwarmed room. Less frequent inhalations 
usually suffice. The tincture of benzoin may be 
omitted and the steam alone used if desired. If 
the patient objects to the use of the towel, the same 
result may be secured by putting over the pitcher 
a cone of paper, the upper end being directed to- 
ward the patient's face, so that he may readily ^jn- 
hale the steam. 

The mixture of syrup of ipecac, sweet spirits of 
niter and water is about as good as anything we 
can scare up while the cough is dry and the sputum 
scanty, but in a day or two the cough becomes 
looser and matter is continually coughed up and 



BRONCHITIS. 173 

Spat out. This matter is viscid, tenacious and raised 
with difficulty, and we need something which will 
loosen things up, so that the cough will become 
easier and the matter may be raised with less effort. 

One of the most successful cough mixtures for 
this stage is composed of one dram each of am- 
monium chloride, ammonium carbonate and am- 
monium bromide, four drams of the fluid extract 
of licorice, and water enough to bring the quantity 
up to six fluid ounces. This may be put up at 
any drug store. The dose for an adult is two tea- 
spoonfuls every three or four hours. 

If preferable, lozenges of ammonium chloride and 
licorice, each lozenge containing two grains of am- 
monium chloride, may be easily obtained and will 
answer the same purpose. Two or three of these 
should be taken every four hours. 

Gradually the cough becomes free and the expec- 
torated matter is easily gotten rid of, and when this 
occurs these remedies should be discontinued, or 
used at much longer intervals. Some form of tonic 
is advantageously employed as convalescence pro- 
gresses. For those who can take it, codliver oil 
is excellent at this stage. Any good form of iron 
tonic is useful, and perhaps the best is the tincture 
of the chloride, which should be taken in ten-drop 
doses in water three times a day after meals. Small 
doses of quinine, two or three grains three times a 
day, may also be taken with advantage. 



174 COLDS^ COUGHS AND SORE THROATS. 

In using these remedies, keep the end in view. 
The Steam inhalations are advantageous through 
the two earHer stages of the disease, in which the 
ipecac and ammonia compounds are employed. 
The medicines in which ipecac is the main factor 
are to be exchanged for the ammonia compounds 
as soon as the matter on the lungs is freely formed, 
and the ammonia compounds are to be used only 
until the cough becomes easy and the matter is 
coughed up without straining or exertion. After 
this, the severity of the disease is over, and the 
patient only needs to recover strength and get back 
to his normal condition, so tonics and attention to 
the general health are the things needed. 

In old people and in very young children, the 
disease manifests itself by slightly different symp- 
toms, and as, owing to infancy or advanced age, 
the power of resistance is less, it is far more likely 
to prove dangerous. 

Small children may not have a chill, or it may 
pass unnoticed ; they do not cough out the sputum, 
but swallow it, and they cannot describe their sub- 
jective symptoms, so that increased rapidity of 
respiration is perhaps the most valuable and trust- 
worthy sign of bronchitis in this class of patients. 
They naturally breathe much more rapidly than 
adults, so that thirty or forty respirations per min- 
ute may not be alarming, but when it reaches fifty, 
sixty or even seventy, it is a danger signal and 



BRONCHITIS. 175 

you may be sure that something is wrong. When 
there is also fever, usually higher than in adults, 
and a cough, the probabilities are in favor of bron- 
chitis or some form of pneumonia, and you had 
better send for a doctor. 

In the aged, as in children, bronchitis is a dan- 
gerous disease, liable at any time to run into bron- 
cho-pneumonia. Fever is not marked but weakness 
is, and the breathing is very rapid. Whereas chil- 
dren do not cough out matter because they swallow 
it, in old age there is actual inability to raise the 
matter at all, and this adds to the danger. For old 
people the chief difference in treatment from that 
prescribed in the case of hearty adults is the greater 
usefulness of the bronchitis tent, to be described 
hereafter. The remedies used and the doses given 
should be as indicated above, but the bronchitis 
tent should be substituted for the steam inhalations. 
For children, however, while the same remedies 
should be used, the doses should be materially 
smaller. The ipecac mixture should be diluted to 
half its strength (in other words, add its own 
volume of water) for their use. For a child of one 
year, give a teaspoonful every four hours, and to 
children of two years and over, two teaspoonfuls 
at the same intervals. For a child of from eight 
to twelve, the same doses may be given as to an 
adult, using the diluted mixture instead of the full 
strength. When the ammonia compound becomes 



176 COLDS, COUGHS AND SORE THROATS. 

necessary, make the dose for a child of twelve years 
half that prescribed for an adult; for one of six 
reduce it to a quarter, decreasing it proportionately 
for still younger children, and giving it in water to 
lessen the strong, salty taste. 

For both small children and old people a physi- 
cian should be in charge, but when this is not possi- 
ble, it is well to make use of the bronchitis tent 
and croup kettle all through the attack, and until 
the patient is decidedly on the way to recovery. 
Time is of little value to these patients, and the 
complete rest involved is in itself beneficial. 

This treatment is not elaborate, involving only 
the arrangement over the bed of the patient of a 
tent-like structure which is useful in retaining steam 
or other medicated vapors, in keeping a uniform 
temperature and in preventing drafts. It may be 
made from home material, or may be constructed 
of unbleached muslin or other cheap cloth. A piece 
of scantling, a pole, or even a broomstick, is fasten- 
ed to each bedpost so as to extend three or four 
feet above the mattress, cross pieces are fastened 
between each two posts, and a single sheet fastened 
over the top of all with pins or coarse stitches. 
Other sheets or cloths are fastened, falling lower 
than the mattress at each end and on one side, 
while on the remaining side two sheets are arranged 
like curtains, thus furnishing an opening about the 
middle for ventilation, and to prevent too complete 



BRONCHITIS. 177 

isolation of the patient. The whole arrangement 
forms a neat Httle room, the size of the bed, in 
which the patient makes his home during the ill- 
ness, and in which children may have their pictures 
and toys, while the aged have their books, writing, 
sewing, or whatever else they are interested in. 

The croup kettle is a device for generating steam 
in the sick room or for inhalation, and does not 
materially differ from an ordinary tea kettle. As 
sold in the stores it usually consists of a cylindrical 
kettle to contain the water, with a close-fitting lid 
in which are two openings. The larger opening 
is funnel shaped for reception of the water and 
whatever drug may be added, and is closed with 
a large cork or a metal plug; the other is in the 
form of a spout. Extra joints, much like those of 
a stovepipe, are provided so that this spout may be 
lengthened and the steam liberated under the bron- 
chitis tent, near the face of the patient or wherever 
most convenient. The heating device is an alcohol 
lamp, and a partial cylinder of metal fits the bottom 
of the kettle, like a pan of the same diameter as 
the kettle and enclosing the lower end of the same. 
One side is open to permit of lighting the lamp, 
or removing it for filling or other purposes. 

The croup kettle may be used in the invalid's 
room without the bronchitis tent, or it may be set 
near the tent with the lengthened spout running 
under the canopy, and thus keep the air constantly 



178 COLDS^ COUGHS AND SORE THROATS. 

moist and, if so desired, medicated. The compound 
tincture of benzoin is a favorite medication for use 
in the croup kettle, a teaspoonful to a tablespoonful 
to each pint or quart of water placed in the kettle, 
or ten to twenty grains of menthol to the quart of 
water may be used. 

To summarize: Bronchitis is a painful and pos- 
sibly dangerous disease at any age, but the chances 
of danger are much increased when it attacks a 
young child or an old person. At any age, the first 
steps should be to overcome constipation and induce 
free perspiration. When this treatment is not im- 
mediately successful, the ipecac mixture prescribed 
above should be taken, in doses varying according 
to age, until the cough is no longer dry, and there 
is much matter to be raised. At this stage the 
ammonia compound should be given, and continued 
until the secreted matter is raised easily, when it 
should be discontinued and tonic treatment adopted. 
For both the very young and the old the danger 
of unfavorable complications is best guarded against 
by the free and continued use of the bronchitis 
tent with the croup kettle. For either of these 
classes, however, a physician should be in attend- 
ance. 



CHAPTER XII. 
COUGH (Cold on the Chest^ Severer Forms). 
Pneumonia. Broncho-Pneumonia. Pleurisy. 

These acute inflammations of the lung structure 
itself, or of its investing membrane, are all danger- 
ous diseases, and in them home treatment should 
only be attempted when the presence of a good 
doctor is an absolute impossibility. 

Lobar Pneumonia. This, the common form of 
pneumonia, is also known as lung fever and cold 
on the chest. It is an acute, infectious disease, 
characterized by inflammation of the lung substance. 
Its onset is usually with a severe and protracted 
chill and fever, sharp, stabbing pain in the chest, 
persistent and painful cough, and rapid, painful 
respiration. 

Lowered vitality is the greatest predisposing 
cause, and for this reason chronic drunkards fall 
easy victims. Old people, feeble individuals and 
young children, when exposed to low temperatures, 
are also frequently attacked, and in all of these 
cases the disease is very dangerous. 

Exposure to cold was formerly regarded as the 
commonest exciting cause of pneumonia^ but it is 

179 



l8o COLDS, COUGHS AND SORE THROATS. 

now believed to be only a predisposing cause, act- 
ing by lowering the vitality. However this may 
be, sudden chilling or long exposure to low temper- 
ature is frequently followed with much promptness 
by an attack of pneumonia, and one attack pre- 
disposes to another by leaving the victim in a con- 
dition of lowered vitality which favors a fresh 
onslaught. 

The real exciting cause is a bacterium, variously 
known as the micrococcus lanceolatus, the pneumo- 
coccus or the diplococcus pneumoniae. Other or- 
ganisms may be able to produce pneumonia, but 
that this wicked and ever-present germ is able to 
do the business there can be no doubt. How long 
it takes after exposure to infection for the disease 
to develop has not been determined. The period 
is probably very short, always provided the patient 
is in a condition of lowered vitality, which allows 
the bacteria to multiply. The germs of pneumonia 
are found in the mouths of a large percentage of 
ordinarily healthy persons, and in such cases when- 
ever anything depresses vitality sufficiently, the 
germs become active and the person becomes sick, 
and the name of his disease is pneumonia. 

Another cause that puts the tissues themselves 
in such condition of lowered vitality that the bac- 
terium is able to do his nefarious work, is any 
bruise or injury to the chest walls. Pneumonia 
originating in this way is known as traumatic or 
contusion pneumonia. 



PNEUMONIA^ ETC. l8l 

The onset of lobar pneumonia is usually with 
great suddenness. Sometimes there are symptoms 
of a slight cold for a day or two preceding the 
direct attack; at other times there are no premoni- 
tory symptoms at all. The chill comes on with 
considerable severity. Sometimes a person goes 
to bed and to sleep, apparently in perfect health, 
and awakes in the night in the midst of a very 
severe chill. At other times the chill attacks in 
the midst of the duties of the day, and with such 
violence that it is hard work for the patient to get 
home. And the chill is not only of great severity, 
but is also long in duration, perhaps lasting a half 
hour or more. The fever rises rapidly and in ten 
or twelve hours may be as high as 104 or 105 de- 
grees, and high it remains till the disease is spent. 
Pulse and respirations both advance with the tem- 
perature, the pulse to about 100 or 120, the respi- 
rations to 30, 40 or even 50, and in children to 
80 or even 100. Headache and pains in the limbs 
and back are common at this stage, and in a few 
hours from the time of the chill, pain in the side, 
stabbing, severe and agonizing, and made worse by 
breathing, coughing or change of position, comes 
on. It is accompanied by a short, dry cough and 
rapid breathing, both of which greatly intensify 
this agonizing ^'stitch in the side." This pain is 
due to a certain amount of pleurisy which accompa- 
nies and is dependent on the inflammation of the 



1 82 COLDS, COUGHS AND SORE THROATS. 

lung. The rapid breathing is of course very pain- 
ful, while the cough makes the poor victim wince, 
or even cry out. Usually the cheek on the affected 
side is much flushed, but occasionally both cheeks 
show this feverish brilliancy. The patient lies on 
the affected side in an effort to restrict its motion 
and so lessen the pain. 

In children the onset is often with a convulsion 
instead of the severe chill, and there may be vomit- 
ing. In drunkards and old people the disease may 
come on gradually and without chill, and in these 
classes there may be little or no cough. In drunk- 
ards the symptoms are often those of delirium 
tremens, and it is only on taking the temperature 
that a suspicion of the real trouble arises. 

The sputum, or coughed-up matter, in pneumonia 
is peculiar. At first scanty, it soon becomes more 
plentiful, but is so tenacious that a cup nearly full 
of the matter may be turned upside down and held 
in that position for some seconds without spilling. 
In hearty adults it is usually blood-streaked or 
tinged, changing in a day or two to the "rusty 
sputum" so characteristic of pneumonia. In drunk- 
ards and very debilitated subjects, often in the aged, 
it may be dark-colored and fluid, what is known as 
''prune-juice" expectoration. 

Constipation is apt to be present in pneumonia, 
digestion disturbed and the tongue coated. The 
fever is remarkably steady, varying but little either 



PNEUMONIA, ETC. 183 

in the course of the day or in the course of the 
disease, and the other symptoms remain nearly the 
same for a variable number of days, which is sin- 
gularly almost always an odd number. In excep- 
tionally fortunate cases the third day witnesses the 
crisis; usually this occurs on the fifth or seventh 
day, but sometimes on the ninth or eleventh. A 
slight rise of temperature may precede the crisis, 
but when this point is reached the fever declines 
rapidly, and in from five to twelve hours has fallen 
to normal, or perhaps a trifle below. A free per- 
spiration accompanies the fall of temperature and 
all the symptoms are greatly mitigated, so that from 
extreme pain the patient passes into a condition of 
comparatively delicious comfort. Sometimes this 
change takes place in the course of a single hour. 
From this period, in favorable cases, recovery is 
rapid and satisfactory.^ 

The patient should occupy a bright, cheerful 
room, thoroughly well ventilated and allowing 
plenty of sunshine if possible. Only one or two 
persons should be allowed in the room at a time 
and in this, as in all other diseases, the pernicious 
habit of making the sick room a reception chamber 
for afternoon callers should be discouraged. The 
patient should be carefully sponged with tepid water 
once or twice daily, a process which, if managed 
properly, need cause but slight disturbance. The 
mouth and teeth should be kept clean, both as a 



184 COLDS, COUGHS AND SORE THROATS. 

measure of comfort and to prevent further infection 
either of the patient or others. The bowels must 
be kept regular and rather free. Water or lemon- 
ade should be given freely. If, as sometimes hap- 
pens, the patient should become delirious or other- 
wise incapable of making his wants known, plenty 
of water or lemonade should be given just as medi- 
cine is given, and at stated intervals. Food should 
be liquid or semi-liquid and easily digested. Milk, 
alone or mixed with food prepared from cereals, 
is usually well taken, and eggs soft-boiled or raw 
are excellent. 

When a physician is in charge the almost in- 
tolerable pain in the side may best be relieved by 
morphine. This very useful, but very dangerous 
drug, is not as a rule considered a safe one to 
handle in the household. Dover's powders, how- 
ever, in three to five-grain doses, may be used, and 
after the disease is established these powders give 
much relief, especially when the cough is trouble- 
some. Either hot or cold applications to the affect- 
ed side may give great relief. Whether to use heat 
or cold should be decided by the feelings of the 
patient. Heat may be applied by means of a small 
flattish bag of salt or sand, five or six inches square, 
which may be heated on the stove or in the oven, 
laying it on blocks of wood to avoid burning the 
bag. Care must be taken that it is not hot enough 
to pain or harm the patient. If the patient finds 



PNEUMONIA, ETC. 185 

cold the more comfortable application, an ice bag, 
or the bladder of a pig or sheep filled with pounded 
ice and tightly tied, may be laid over the seat of 
pain. These ice-containers must be wrapped in a 
towel or other moderately thick cloth, to prevent 
too much chilling and to absorb moisture. Either 
hot or cold applications may be conveniently made 
by means of compresses (towels or sheets of flannel 
folded to a suitable thickness), wrung out of either 
very hot or very cold water and laid over the painful 
point. The cold compresses must be frequently 
renewed, while the hot applications may be covered 
with oiled silk, rubber cloth or other impervious 
fabric which will retain the heat for some time. 
Poultices are still used in many parts of the coun- 
try and when properly managed they certainly seem 
to do good. The cotton jacket is also serviceable 
in the case of aged patients or others deficient in 
bodily warmth. It consists of one or two layers 
of cotton batting stitched on to a thin undershirt 
so as to make a complete covering for the chest, 
the outer part being covered with oiled silk. For 
younger patients, a light flannel garment is ordi- 
narily more comfortable, and there is less danger 
of a fresh cold when it is removed. 

Cold sponging, or in case of weakly patients, 
sponging with tepid water, should be used for the 
relief of fever. It may be done limb by limb so 
that the patient is not much disturbed, and the effect 



l86 COLDS, COUGHS AND SORE THROATS. 

is always good. In a majority of the cases of 
pneumonia, alcoholic stimulants may be used with 
advantage. It may not be required at the beginning 
of the disease, but in a day or two its need will 
become apparent. Tw^o or three ounces of whiskey 
in twenty-four hours will be about right for a robust 
adult, but if the pulse becomes weak or other evi- 
dences of failing strength appear, the quantity may 
well be increased, even to ten or twelve ounces in 
a day. 

Broncho-Pneumonia, Bronchitis signifies inflam- 
mation of the bronchi; pneumonia, inflammation 
of the lungs. Broncho-pneumonia means an in- 
flammation which involves parts of both structures. 

To explain how broncho-pneumonia differs from 
lobar pneumonia, a little consideration of the lung 
structure is necessary. Each lung is made up of 
large separable masses called lobes. The right lung 
contains three of these masses, the upper, middle 
and lower lobes, while the left lung contains but 
two, the upper and lower lobes. Where one would 
naturally expect to find a left middle lobe, he finds 
the heart, which unfortunate organ, owing to the 
needs of novelists and other romancers, has very 
little tendency to the right and is always getting 
left. Each lobe of each lung is composed of in- 
numerable lobules, each lobule consisting of a ter- 
minal bronchus and its group of air-cells. These 
lobules (terminal bronchioles and air cells) are the 



PNEUMONIA^ ETC. 187 

parts attacked in broncho-pneumonia, and the re- 
sulting hmited areas of inflammation are found 
scattered about in both lungs, favoring as a rule 
the lower lobes. In lobar pneumonia, on the con- 
trary, the inflammation is usually confined to one 
or two lobes of one lung, and all parts of the affected 
lobe participate in the inflammation. Broncho- 
pneumonia is called lobular pneumonia from the 
structures attacked, bilaterial pneumonia because it 
is found on both sides (whereas lobar pneumonia, 
as a rule, is limited to one side), and capillary 
bronchitis from the minute size of the bronchi in- 
volved. 

There are at least three forms of broncho-pneu- 
monia, differing in causes, symptoms and to a con- 
siderable extent in danger. Primary acute broncho- 
pneumonia is very much like lobar pneumonia, in 
causes, symptoms and treatment. It is considered 
especially dangerous to the very young, and to old 
or feeble persons. 

Secondary broncho-pneumonia attacks the vic- 
tims of other diseases at a time when the vital 
forces are low from severe or long continued sick- 
ness, and is very fatal. In this form there is no 
initial chill, but the disease comes on gradually, and 
according to Dr. Osier, in measles, diphtheria, 
whooping cough, scarlet fever, smallpox, erysipelas 
and typhoid fever, kills more than die directly from 
the original disease. 



l88 COLDS, COUGHS AND SORE THROATS. 

There is still another form called deglutition or 
aspiration pneumonia, which is common after oper- 
ations on the nose and mouth in which chloroform 
or ether has been used. It is caused by particles of 
food, mucous or other secretions passing into the 
larynx and finally lodging in the minute bronchioles 
where a dangerous and often fatal inflammation is 
started. 

All forms of broncho-pneumonia are caused by 
bacterial infection, although as we have just seen, 
the causes leading to the degree of lowered vitality 
which permits of bacterial activity may be very 
different. 

Primary acute broncho-pneumonia may set in 
with much suddenness, as does lobar pneumonia, 
with a chill or convulsion. Fever rises rapidly and 
remains high, cough may be severe and painful, 
and the termination by crisis as in the lobar form. 

In the secondary form the chill or convulsion is 
absent. Fever rises gradually, shortness of breath 
and increased rapidity of respiration become mark- 
ed, and a hard, dry cough becomes very annoying. 
The difficulty of breathing becomes more and more 
decided, fingers and lips take on a bluish shade, 
and the patient is restless and evidently suffering 
from lack of oxygen. If the case terminates fatally, 
drowsiness from deficient air supply takes the place 
of restlessness, all the symptoms decline and finally 
cease in death. 



PNEUMONIA, ETC. 189 

In the primary form, where the symptoms largely 
resemble lobar pneumonia, the treatment is similar. 
In the secondary form, coming on after exhaustive 
disease, treatment is similar but more care must be 
given to keeping up the strength, and where there 
is difficulty in breathing, the air of the room should 
be kept moist as in bronchitis or membranous croup. 
A kettle of water may be kept constantly boiling in 
the room or large lumps of unslaked lime occasion- 
ally dropped in a pail or tub of water. Small doses 
of Dover's powder may be used when the cough is 
distressing, the bowels must be kept regular, as in 
lobar pneumonia, and stimulants are even more 
necessary. Plenty of cold water or lemonade must 
be constantly supplied, and white of tgg, mixed 
with cold water and sugar, makes an admirable 
vehicle for stimulants. If suffocation threatens, a 
prompt emetic should be administered as in mem- 
branous croup. (See Chapter IX.) 

The best possible treatment of broncho-pneumo- 
nia in the household consists of prevention. No- 
where else is the old adage, *^An ounce of prevention 
is worth a pound of cure," of greater applicability. 
In all acute diseases the possibility, even probability, 
of this disastrous termination must be remembered, 
and after any such disease too early exposure to 
ordinarily harmless cold or dampness must be avoid- 
ed. Dr. Osier lays great stress on the tendency of 
children to kick off the bed clothes and get the 



190 COLDS, COUGHS AND SORE THROATS. 

night robes bundled under the arms, exposing a 
large part of the body to chilling in the colder part 
of the night. As a remedy for this trouble he 
recommends the use of union suits, in which drawers 
and waist being all in one piece, such bunching is 
impossible, and closer watchfulness, especially of 
the sick, as a remedy for the removal of bed cloth- 
ing. Early recognition of sickness and extra care 
at this stage will prevent many children from the 
worst part of the attack, and careful cleansing of 
nose and mouth in health, and more particularly 
in disease, is an efficient means of limiting many 
dangerous maladies. 

Pleurisy, The pleura is a delicate membrane 
which covers and is closely adherent to each lung. 
It also lines and is closely adherent to those parts 
of the inner chest wall and diaphragm which sur- 
round and enclose the lung. The two parts of the 
pleura — that covering the lung, and that lining the 
chest cavity — are continuous, passing from lung to 
chest wall at that part of the lung where the bron- 
chus and great blood vessels enter. Thus it will 
be seen that the pleura forms a closed sac, inter- 
posed between the lung and those structures against 
which it presses and rubs in the process of breathing. 
The pleura of one lung is entirely separate and 
independent of that of the other, these two closed 
sacs only meeting and touching in a portion of the 
mid line in front. 



PNEUMONIA^ ETC. I9I 

In a normal and healthy individual this lining 
and investing membrane secretes a viscid, yellowish 
fluid, which lubricates opposing surfaces and so 
nearly prevents friction that everything moves 
smoothly and without a suspicion of pain. 

Acute pleurisy is an inflammation of this lining 
and investing membrane, with a decreased and 
changed secretion, so that the swollen and tender 
surface of the pleura surrounding the lung rubs 
against that lining the chest, resulting in excruciat- 
ing pain, which gives the characteristic ''stitch in 
the side.'' In some cases the sound made by the 
rubbing of these roughened surfaces is distinct 
enough to be easily heard by the unaided ear; in 
other cases the trained physician with delicate and 
appropriate instruments cannot detect it. Breath- 
ing, coughing, or any movement of the body that 
brings these surfaces together, causes the most in- 
tense shooting or stabbing pain; hence the victim 
usually lies on the affected side, restrains the breath- 
ing, and tries to stifle the cough. Fortunately the 
cough in pleurisy is not as constant and severe as 
in pneumonia. Pleurisy is almost always present 
in greater or less degree in pneumonia, and causes 
this same sharp, stabbing pain. 

Exposure to cold or dampness is the commonest 
cause of pleurisy. As in pneumonia, however, a 
localized injury to the chest wall may so lower the 
vitality of the damaged tissues as to cause an at- 



192 COLDS, COUGHS AND SORE THROATS. 

tack. It is quite probable that bacteria of some 
kind are always a necessary factor in the causation 
of pleurisy, but as they only become active when 
exposure or other debilitating circumstances have 
sufificiently lowered the vitality of the individual, or 
when a bruise or other injury has lowered the vitali- 
ty of the pleura itself, it seems only fair to account 
the exposure or injury as the primary exciting cause, 
and the bacteria a secondary cause. 

The pneumococcus, or micrococcus lanceolatus, 
the organism that most commonly causes lobar 
pneumonia, is very frequently the active agent in 
producing an attack of pleurisy, but other forms 
of germ life are abundantly effective factors. Tu- 
berculosis is frequently first manifested in an attack 
of pleurisy, and in this case the bacillus tuberculosis 
is, of course, the guilty party; likewise the disease 
is prone to become chronic and last indefinitely. 

Pleurisy may set in suddenly with a chill, fol- 
lowed by fever and the characteristic stabbing pain 
in the side. At other times it commences gradually, 
pain and fever developing slowly. Cough is a com- 
mon symptom in the early stage, but it is not so 
severe as in pneumonia, and the fever is not only 
slow in development, but fails to reach as high a 
point as in pneumonia, 102 to 103 degrees being 
ordinarily its height. The pain in the side is the 
most characteristic symptom. It is commonly lo- 
cated at the side of the chest a little below the 



PNEUMONIA^ ETC. I93 

nipple. It may, however, occur at other points, 
at the back, in front, or even at some point in the 
abdomen. Appendicitis has more than once been 
diagnosed when the real trouble was pleurisy. 

This stage of pleurisy is known as dry or fibri- 
nous pleurisy, because the secretion of the pleura 
is comparatively dry and tenacious. In fortunate 
cases this is the extent of the disease, and recovery 
takes place promptly. Yet, even when it terminates 
at this stage, adhesions are liable to take place be- 
tween the two layers of pleura, the sticky, tenacious 
secretion takes on an organized structure binding 
lung surface to chest wall and a certain limitation 
of movement lasts through life. 

More commonly, after the dry stage has lasted a 
few days, the secretion becomes more liquid and 
copious. Fluid accumulates between the layers of 
the pleura and the stabbing pain ceases as the pleural 
layers are separated by the accumulating fluid. If 
much effusion takes place there is a noticeable bulg- 
ing of the chest wall, and breathing becomes diffi- 
cult because of pressure on the lungs. This is what 
is known as serofibrinous pleurisy, or pleurisy with 
effusion. After a variable time, a few days or two 
or three weeks, the fluid ^*s gradually absorbed, the 
other symptoms abate arid recovery takes place, but 
probably with more of adhesion between the pleural 
layers than in the usually more circumscribed dry 
or fibrinous pleurisy. 



194 COLDS, COUGHS AND SORE THROATS. 

If this fluid instead of disappearing takes on a 
purulent form, that is, becomes largely changed to 
pus, or if in the first instance pus accumulates in- 
stead of serous fluid, we have a third and more 
serious form of pleurisy, known as empyema, or 
purulent pleurisy. 

If a physician is in attendance he may strap the 
chest to relieve the pain in the dry form. If the 
effusion is great in quantity in the second form he 
will probably tap it; that is, insert a hollow needle 
joined to a rubber tube, or to some apparatus de- 
signed to exercise pneumatic pressure in withdraw- 
ing the fluid. In the third form he will probably 
have to cut out a portion of one rib to withdraw 
the semisolid pus. In addition, he will give reme- 
dies to control the fever, use morphine for the pain, 
alleviate the cough and give whatever other medi- 
cation the case requires. 

If the case must be treated at home, a bandage 
may be drawn around the chest, partially restraining 
movement in respiration, but unless it surely ren- 
ders the patient more comfortable it had better be 
taken off. The patient naturally lies on the affected 
side in dry pleurisy, and usually on the sound side 
in pleurisy with effusion, and this he must be al- 
lowed to do. If the fever is high, cold sponging 
or bathing in tepid water, as may be most pleasant 
to the patient, may be resorted to. Plenty of cold 
water or lemonade must be supplied for drinking 



PNEUMONIA, ETC. I95 

purposes, and if the pulse grows weak, give alcohol 
as in pneumonia. The diet must be largely liquid 
but nourishing, and whatever can be done to give 
the patient relief must be attended to. 

To summarize: In the case of such serious dis- 
eases as pneumonia and pleurisy, the great point 
is to be able to recognize them in their early stages. 
Then, having recognized them, there is but one 
thing to do : secure the best medical skill available. 
Only where this is an impossibility should home 
treatment be considered. 

Whenever very rapid respiration, fever and a 
high pulse occur in one individual, there is ground 
for suspecting the existence of lung trouble. If 
these symptoms come on with some degree of sud- 
denness, and especially if stabbing pain in the side 
accompanies them, the suspicion becomes almost a 
certainty, and a doctor should be sent for at once. 

Where a physician cannot be obtained, careful 
nursing is the most important thing. There should 
be plenty of fresh air without drafts or chilling, 
sunlight whenever it is agreeable to the patient, 
light bed clothes, and not too many of them, quiet 
restfulness for the invalid, very few others allowed 
in the room, and none at all save one nurse when- 
ever the patient can gain rest and sleep. Plenty 
of good cool water, lemonade or other thirst-allevi- 
ating drinks should be allowed the patient. The 
food should be light and nutritious in character, 



196 COLDS, COUGHS AND SORE THROATS. 

and daintily prepared and served, little of it in the 
onset of a disease characterized by fever, and more 
and stronger diet as the fever subsides and appetite 
makes itself felt. Such care as this will often save 
where medical skill and application, without these 
home adjuncts, must surely fail. 

Slight precautions have often much effect in 
avoiding or preventing attacks of these diseases. 
Cleanliness of mouth and nose is important as a 
preventive measure. A little care in avoidance of 
exposure may save a dangerous illness, especially 
in the cases of children and elderly people. 



CHAPTER XIII. 
La Grippe or Influenza. 

This disease of many manifestations has also 
many names. Of these, perhaps la grippe, or the 
grip, is the commonest. It is also known as in- 
fluenza, epidemic catarrhal fever and catarrhal in- 
fluenza. In its commonest form it very much re- 
sembles a severe case of our familiar old cold in 
the head, nasal catarrh or coryza. The main differ- 
ence is that la grippe is so much worse, and in 
almost all instances extends to other parts of the 
upper respiratory tract so that cough, hoarseness, 
substernal pain and rawness, and often other symp- 
toms, so varied that no one description can apply 
to every case, are an almost invariable accompani- 
ment. An ordinary cold in the head is regarded 
as simply troublesome, whereas la grippe is often 
dangerous, sometimes fatal, and always depressing 
and exhausting. 

The authorities tell us that la grippe itself rarely 
proves fatal, but as they always add that the victim 
is quite likely to die of complications or sequelae, 
this is little consolation to the ordinary individual 
who doesn't care much whether his obituary reads 
"la grippe" or something else, and when the afore- 

197 



198 COLDS, COUGHS AND SORE THROATS. 

said individual does die it is hard for his friends 
to believe that la grippe should not be charged up 
with the damage. However, this does not affect 
the practical point, which is to avoid la grippe, or 
if that is impossible, so modify or ameliorate it that 
the victim does not die, either of it or something 
else for which it is responsible. 

La grippe is supposed to bear much the same 
relation to our domestic coryza that Asiatic cholera 
bears to cholera morbus. While it is believed that 
at some times and under some circumstances bac- 
teria may either cause or intensify either of the 
home-grown complaints, it is known that each of 
these malignant invaders from the East depends 
for its existence on the activity of a specific micro- 
organism, and also in each instance that the foreign 
visitant may be of much greater severity and danger 
than the domestic plague. 

La grippe, in its commonest form, resembles an 
intensified coryza with an inevitable extension to 
other parts of the upper respiratory tract. It sets 
in with a distinct chill, fever of loi to 104 degrees 
following. There are commonly severe muscular 
pains in legs and back, sometimes in all the mus- 
cles, headache is apt to be of great severity, ear- 
ache is common, and deep-set pain back of the eye- 
balls is supposed to be almost characteristic. Muscu- 
lar weakness and mental depression are so common 
and so marked that one eminent authority says, 



LA GRIPPE OR INFLUENZA. 1 99 

"It is this striking feature of extreme mental and 
bodily depression and weakness which distinguishes 
true grippe from the ordinary catarrhal cold/' Se- 
vere sneezing comes on, the eyes are red and swollen 
and cannot tolerate light, cough, hoarseness and 
pain back of the breast-bone follow, and the pulse 
is weak and rapid. The fever may be of only two 
or three days' duration or may last for a week, 
two weeks or even longer. After it leaves, recovery, 
tedious and exasperatingly slow, commences. 

In other cases, as in coryza, sneezing, more severe 
than in the milder complaint, is the first symptom, 
followed by chilliness, fever, sore throat and cough, 
the latter so irritable and painful as to frequently 
prevent sleep. There are also other forms, the neu- 
ralgic commencing with intense headache and 
shooting pains; and an abdominal type marked by 
vomiting and diarrhoea, intestinal cramps and other 
symptoms in the region of the stomach and intes- 
tines, but in any form various symptoms properly 
belonging to some other type may manifest them- 
selves, so that la grippe may be and often is of so 
many and various symptoms that no description 
will fit every case, and it is rightly styled a disease 
of protean manifestations. 

La grippe in its severer forms is a disease of so 
much gravity, so prone to complications and unfor- 
tunate sequelae, ofttimes so refractory to treatment 
and so uncertain in its course and termination, that 
home treatment is hardly advisable- 



200 COLDS^ COUGHS AND SORE THROATS. 

At the outset the same remedies should be used 
as for an ordinary coryza. Calomel and salts should 
be given to secure free bowel action ; a hot mustard 
foot bath to bring on free perspiration, and a glass 
of hot toddy or lemonade, finishing up the sweat 
between warm blankets, with a good d^ose of quinine 
and Dover's powders after getting into bed. Fre- 
quently these measures, if taken at the very begin- 
ning, will be effective and la grippe, robbed of his 
terrors, goes sulkily in search of a more heedless 
victim. To this extent we believe in home treat- 
ment. At this point, however, if the disease per- 
sists with any degree of severity, secure the best 
medical skill at command, and give the same care 
and attention as if dealing with typhoid, smallpox 
or yellow fever. 

If, however, from force of circumstances, home 
treatment must be continued, very much is possible. 
Of first importance is rest, as nearly absolute as can 
be secured, and it may almost be said that this is 
the greatest and most important part of the treat- 
ment. Add to this careful nursing and suitable 
diet and you have the three greatest points of home 
treatment. Drugs, however, must not be neglected 
Properly administered they are agents of great use- 
fulness, but — first, rest; second, careful nursing, 
and third, judiciously careful feeding; then drugs, 
few in number, given with full knowledge of what 
they are expected to accomplish — these comprise 
the domestic treatment of la grippe. 



LA GRIPPE OR INFLUENZA. 201 

As in all other diseases where constipation is 
likely to prove troublesome, at least one good bowel 
movement should be secured daily. In grippe, how- 
ever, more care must be taken than in most diseases 
to guard against too much purgation, since this 
exhausts the strength, and to conserve all possible 
strength is one of the most important points in this 
markedly prostrating disease. After the initial dose 
of calomel and salts, some mild laxative must be 
chosen and the dosage carefully graduated to the 
case. Suppose one of the cascara cordials is the 
selected remedy. A teaspoonful being given the 
first night may produce too much purging. Then 
next night give half a teaspoonful, while if a tea- 
spoonful fails to produce sufficient results, one and 
a half teaspoonfuls may be given the next night, 
or a half spoonful given in the morning. Or sup- 
pose one of the tonic cathartic pills has been given 
without results. Then in the morning give another, 
or at night give two, or one and the half of another. 
To get exactly the proper dose, neither more or 
less, is worth all this attention, as the strength must 
not be reduced by any excess of purgation, and 
at the same time we want no retained poisons to 
weaken the vital forces and aid the disease. 

Salol may be given in five-grain tablets, or in the 
same dose in capsules, three or four times a day. 
This acts as an intestinal antiseptic and seems to 
be particularly useful in this disease. 



202 COLDS, COUGHS AND SORE THROATS. 

If the fever is high, cold sponging is the most 
reHable remedy, and after the sponging the skin 
must in all cases be rubbed till dry and if possible 
in a glow. The after rubbing is of fully as much 
importance as the application of the cold water, and, 
if any large surface is involved, should never be 
neglected. If fever powders or other antipyretics 
are used it should be under the direction of a skilled 
physician, and they should be obtained and used 
under their proper names, as acetanilid, phenacetin, 
or whatever may be chosen. Thus used they are 
excellent, but to get some unknown combination 
of these powerful, and, if wrongly used, dangerous 
drugs and give without full knowledge as to their 
action is, to say the very least of it, injudicious 
to an extreme. Sweet spirits of niter is a very 
safe and mild fever remedy and a great favorite 
in many households. It may be given in teaspoon- 
ful doses to adults, repeated in an hour or two if 
necessary. 

A child a year old can take as much as five or 
ten drops, and for patients between these ages the 
dose should be modified proportionately. It should 
always be given in water. 

For the severe pains in the back and limbs any 
good liniment is beneficial. At night a Dover's 
powder may be given for the double purpose of 
relieving the pain and securing rest. 

As soon as the bowels are free and the fever is 



LA GRIPPE OR INFLUENZA. 2O3 

subdued, tonics may be given. An excellent tonic 
mixture is composed of three drachms of the citrate 
of iron and quinia, four fluid drachms of the tinc- 
ture of nux vomica and simple elixir enough to 
make up a six-ounce mixture. Of this a teaspoon- 
ful, in water, after each meal, is the adult dose. 

Diet is a matter of great importance. For the 
first few days it should be as nearly liquid as possi- 
ble. If milk agrees with the patient he may almost 
live on it, and as time goes on and he desires 
change, broths may be added, and such preparations 
of milk and eggs as custards, junket, curds and 
whey and so on. Eggnog is fine when convalescing, 
and a solid diet may be gradually resumed. 

With treatment such as outlined above an ordi- 
nary and not too severe case of grippe should do 
well, but care must be taken not to hasten conva- 
lescence. It is better to remain in bed a day or two 
longer than necessary than to get up too soon, and 
after rising ordinary duties should be resumed only 
by degrees and in accordance with the return of 
strength. 

Tonic medication should be continued until re- 
covery is fully assured and for some time the patient 
must be careful of any unnecessary exposure or 
unusual exertion, always remembering that one at- 
tack, instead of conferring immunity, rather pre- 
disposes to another attack or to a relapse. 

If the nasal secretions are increased and the 



204 COLDS, COUGHS AND SORE THROATS. 

mucous membranes swollen, the nose stuffed up and 
breathing interfered with, as is most likely to hap- 
pen, adrenalin sprays and albolene by a nebulizer 
should be used, as recommended in the treatment 
of coryza. For the irritative cough heroin hydro- 
chloride in one-twelfth-grain tablets may be taken 
three or more times a day. Or a tablespoon- 
ful of the compound tincture of benzoin may be 
dropped into a pitcher of boiling water and the 
steam inhaled by holding the face over the mouth 
of the pitcher and laying a towel over head, pitcher 
and all while the medicated steam is inhaled. These 
inhalations may last for from five to ten minutes 
at a time, and be repeated six or eight times in the 
course of the day. Care should be taken not to 
scald the face in the process. 

It is worth repeating here that a severe case of 
genuine grippe or influenza i§ not a disease for 
home treatment, and if the initial sweating fails to 
stop it, medical care should be secured if circum- 
stances allow it. If, however, one is fifty or a 
hundred miles from a doctor, or in other ways 
medical skill is unobtainable, home treatment may 
become a necessity and should be carried out as 
carefully as if a doctor were in charge, remember- 
ing that rest, careful nursing and suitable diet are 
at least half the battle and that what medicines are 
given should be given with a definite purpose, not 
simply to be doing something in the hope that it 
may prove good. 



LA GRIPPE OR INFLUENZA. 205 

There is one admirable thing about this otherwise 
villainous disease — its approach is not insidious and 
stealthy; it advances like an invading army with 
blare of trumpets heralding its approach, and fair 
warning is given those who wish to fight or to flee. 
Frequently, in the severe epidemics, those whose 
means allow it send the aged and children to moun- 
tain and seaside resorts, out of the usual lines of 
travel, and this is a course to be commended. 
Those whose duties require them to face the disease 
can do much in the way of avoiding crowded halls, 
theaters, churches and lecture rooms, crowded cars 
or other conveyances, and restricting social inter- 
course in the height of the malady. Antiseptic 
sprays for mouth, throat, nose and even eyes are 
often used with some measure of success, and a lit- 
tle extra care of the general health and strength 
is very decidedly advisable. 

In many cases of what is probably true grippe, 
the symptoms are so slight as to amount to little 
or nothing more than a bad cold, and in many 
cases a common cold is called la grippe for no other 
reason than that it sounds a little more imposing. 
In such cases as these, if a common cold is of un- 
usual severity it will do no harm to treat it as a 
mild case of la grippe, and if true grippe is so mild 
as to amount to no more than a common cold, no 
harm is done if treatment is proportionately mild, 
but genuine old fashioned la grippe, characterized 



206 COLDS^ COUGHS AND SORE THROATS. 

by prostration and extreme wretchedness from the 
start, with great and increasing weakness as it pro- 
ceeds, must always be looked on as a serious disease 
and worthy of the best skill and care that can be 
obtained. 



CHAPTER XIV. 
Hay Fever. 

Hay fever rejoices in a multitude of names, 
among which may be noted vaso-motor rhinitis, 
hay asthma, rose cold, rose fever, autumnal catarrh, 
catarrhus sestivus and ragweed fever. 

It is commonly claimed that this singular disease 
attacks only individuals of a neurotic or highly 
nervous temperament, and that this nervous tem- 
perament, together with a special susceptibility in 
the nerve endings of the nasal mucous membrane, 
are the principal predisposing causes. One very 
accurate observer, however, claims that some of the 
sufferers are individuals of originally placid tem- 
perament rendered neurotic solely by the keen dis- 
comfort of the disease, so there you are. ''You 
pays your money and you takes your choice,'' but, 
if you suffered as they do, no doubt your tempera- 
ment, no matter how placid at this moment, would 
quickly become as neurotic as theirs. 

Hay fever is a combination of coryza, grippe-like 
in its intensity, with the agonizing paroxysms of 
genuine asthma, and this mixture of two of the 
most painful ailments, each of full strength and 
as ready to do business as if the other partner were 

207 



208 COLDS, COUGHS AND SORE THROATS. 

absent, naturally renders the victims most wretched. 
That same accurate observer already quoted as to 
the neurotic temperament, further comments, 'The 
patient feels so wretched that he becomes extremely 
restless, irritable and melancholic, even, in rare 
cases, to the verge of suicide.'' 

The exciting cause is a mere external irritant, 
ordinarily the pollen or vegetable dust from roses, 
ragweed, golden-rod or other familiar every-day 
flower or weed. In certain individuals a somewhat 
similar condition is brought about by smoke, dust, 
fine air-borne particles of substances used in the 
arts and industries, or chemical fumes and odors. 
A remarkable feature is the extreme regularity of 
its annual recurrence. Frequently the patient can 
tell the very day of the month when the attack will 
commence, and in some cases where time and money 
are at command the attack is avoided by a sojourn 
at some mountain resort or other place where the 
exciting irritant is not found. A sea voyage always 
secures immunity and even after the seizure two or 
three days at sea will put an end to the distressing 
symptoms and the patient is again free from his 
incubus. 

Ordinarily an attack begins much like coryza. 
There may be a dryness of nasal membranes and 
conjunctivae, burning and itching, follow^ed by ex- 
cessive sneezing and a thin watery discharge from 
the nose, while the swollen and congested eyes 



HAY FEVER. 20g 

find some relief in an abundant tearfulness. At 
other times sneezing, incessant and long continued, 
is the first intimation, while again the patient may 
awake at night in the agonies of an asthmatic par- 
oxysm. After a few days of utter misery there 
may be a brief intermission, followed by a longer 
and even more severe exhibition of the same symp- 
toms, or the disease may run steadily on for from 
two or three to eight or ten weeks. 

The only absolute cure or preventive of hay fever, 
applicable to all cases, is, as already mentioned, a 
sea voyage, but there are numerous resorts in our 
own country where most cases find relief. Promi- 
nent among these are the Adirondacks, the moun- 
tainous region of western North Carolina, the 
White Mountains, the Green Mountains, and some 
of the lake resorts. 

Investigations having for their object the dis- 
covery of an anti-hay-fever serum, are being rapidly 
pushed and it is believed with a large measure of 
success. In the meantime the greatest relief may 
be obtained by the use of adrenalin chloride solu- 
tion, first cleansing the nasal passages with some 
mild alkaline solution, a little soda or boric acid 
dissolved in warm water, for instance. Follow this 
by the use of adrenalin solution as set forth in the 
article on coryza, not neglecting to follow with 
albolene by nebulizer, this being especially necessary 
here in order to protect the membranes from more 
of the original irritant. 



2IO COLDS, COUGHS AND SORE THROATS. 

As defects or diseases of the respiratory passages 
are often a powerful factor in producing this dis- 
order, the nose and throat of every hay fever vic- 
tim should be carefully examined by an expert 
specialist, who may be able to detect and correct 
some formi of chronic rhinitis, one or more devi- 
ations or spurs of the septum, thickening or adhe- 
sions of portions of the nasal membranes, nasal 
polypi, or adenoids, the removal or correction of 
which will reduce the liability to this affection, or 
perhaps do away with it altogether. 

Whatever increases the general bodily vigor les- 
sens the liability to this disease, hence careful atten- 
tion to the laws of healthful living would seem 
peculiarly advisable for these sufferers. Tonic 
treatment for some wxeks or months before the 
expected time of attack sometimes gives it check- 
mate. Quinine in five-grain doses three times a 
day, beginning a month before the attack, sometimes 
succeeds, and under medical advice two to five drops 
of Fowler's solution three times a day for several 
weeks, will sometimes be effectual. For children 
the old stand-byes, codliver oil and the syrup of 
the iodide of iron are as good as anything that can 
be given. 



CHAPTER XV. 
Whooping Cough. (Pertussis.) 

This is an acute and very contagious disease, 
chiefly of childhood, and Hable to be found wher- 
ever children are. It takes its name from the 
peculiar long-drawn whoop which follows the par- 
oxysms of coughing when the disease is at its 
height. It occurs with greatest frequency in winter 
and early spring when children are gathered to- 
gether in school houses, which in cold and damp 
weather are tightly closed and vary in temperature 
from very chilly to much too warm. Instances are 
recorded (about a dozen cases all told) of its oc- 
curring the second time, but usually one attack 
protects, and this, combined with its being so very 
contagious, gives it the reputation of being a dis- 
ease of childhood. If any one really escapes in 
early years he is still susceptible to the disease, 
but mild attacks are not uncommon in which the 
characteristic whoop may not appear at all or not 
markedly enough to be recognized, and the fortu- 
nate subject of such an attack never knows the real 
cause of his immunity. 

Whooping cough and measles are so frequently 
associated with each other (usually the attack of 

211 



212 COLDS, COUGHS AND SORE THROATS. 

whooping cough following shortly after that of 
measles) that they are believed to be somehow 
related. Both diseases are believed to be of germ 
origin, but as the germs have not yet been surely 
detected in either case, their exact relationship can 
not be determined. 

The great danger in whooping cough lies in its 
preparing the way for other diseases, and, though 
it ranks very high as a cause of death in infancy 
and childhood, so high an authority as Dr. Hare 
says it is not in itself fatal, and if complications 
can be prevented the patients always get well. 
Broncho-pneumonia and pulmonary tuberculosis 
(consumption) are its most dreaded and commonly 
fatal complications, and the fact of its paving the 
way for these deadly diseases indicates very clearly 
the importance we should attach to whooping cough 
itself. General convulsions are a complication 
sometimes brought on by the severity of the par- 
oxysms of coughing, and this has resulted fatally. 

Whatever lowers vitality predisposes to whoop- 
ing cough, and its frequent occurrence after an at- 
tack of measles has already been referred to. The 
exciting cause is, of course, exposure to the con- 
tagion, that is, coming into contact with some one 
who has the disease, or with some article or person 
who has been so exposed. The period of incubation, 
which is the time elapsing between exposure and 
the beginning of the sickness, varies from two days 
to two weeks. 



WHOOPING COUGH. (PERTUSSIS.) 213 

It usuall)^ commences like a mild cold in the head, 
with which cough is soon associated, or the cough 
may appear before the coryza, and in the early 
stages there is moderate fever as in any other cold. 
It may remain in this form, but with the cough 
increasing, for about two weeks, and during this 
time it is impossible to tell that it is anything more 
than an ordinary cough or cold, but as the number 
of coughs in a series increases, the effort to regain 
breath develops the whoop and the true character 
of the disease is known. At the beginning of the 
whooping stage two or three coughs may be all that 
occur in a paroxysm, and, aside from the following 
whoop, their only peculiarity is the suddenness with 
which the coughing spell bursts out, but the number 
in each series increases until twenty or more may 
follow in such rapid succession that the lungs are 
apparently emptied of air, giving rise to distress- 
ing symptoms of beginning suffocation and fol- 
lowed immediately by the spasmodic intake of air 
which causes the whoop. Sometimes the spasmodic 
effort to regain breath and the inrush of air which 
causes the whoop apparently excite a fresh attack, 
so that two or three series of coughs, each succeeded 
by the characteristic whoop, occur in quick succes- 
sion, or it might be described as one long series 
of coughs interrupted by several whoops. When 
vomiting follows, as it very often does, and the 
paroxysms are of much violence and very frequent, 



214 COLDS, COUGHS AND SORE THROATS. 

it becomes a matter of great difficulty for food 
to be retained long enough to do any good, and 
death by starvation and exhaustion threatens. In 
addition, rest and sleep are almost impossible and 
the condition becomes very dangerous. As a rule 
but little matter is coughed up, but more follows 
in the vomiting and it is very sticky and tenacious. 
The severity of the paroxysms causes congestion 
of the blood vessels of the head, the face is deeply 
flushed, tears run from the eyes, and frequently 
small vessels in the mucous membrane of the nose 
are ruptured and nose-bleeding is added to the other 
symptoms. Ordinarily a small sore appears on the 
under surface of the tongue where it strikes the 
teeth in the coughing spells. 

In some of the rural districts whooping cough 
in the summer time is regarded as a matter of little 
consequence, and parents will intentionally expose 
their children to the disease in order that they may 
have it ''in a good time.'' The youngsters stay out 
of doors almost all of the day time, the doors and 
windows are all open at night, and ill results are, 
as a rule, neither expected nor encountered. The 
best possible treatment is largely indicated by this 
so-to-speak natural method. With an abundance 
of pure, fresh air and sunshine, nothing to excite 
or worry the patient, possibly some mild cough 
remedy and moderate doses of quinine, medical 
skill cannot much improve on it. But unless the 



WHOOPING COUGH. (PERTUSSIS.) 21 5 

disease is mild in type and runs a favorable course 
a doctor should surely be secured. 

Sunshine and fresh air in abundance are consider- 
ed of prime importance in this disease, and if the 
weather is cold or inclement a large, well ventilated 
room must be made as near a substitute as possible. 
The temperature must be uniformly maintained at 
about seventy degrees, and the air kept moist by a 
constantly boiling kettle, or by dropping large lumps 
of unslaked lime in a pail or tub of water. If 
plenty of fresh air cannot be secured without drafts, 
the bronchitis tent should be used and the air kept 
moist by steam, as described in Chapter V. It is 
highly recommended that two rooms should be de- 
voted to the whooping cough patient, one to be 
used as a sleeping room, the other occupied during 
the day, each room being abundantly aired and 
ventilated while the other is occupied. If the sleep- 
ing room is liable to slight drafts, a mosquito bar 
over the bed will afford sufficient protection, and 
ventilation must be good. 

Diet should be light and nourishing. Where the 
paroxysms of coughing are close together and fol- 
lowed by vomiting, try a teaspoonful or two of 
milk after each paroxysm, keeping the little patient 
from gulping or swallowing in haste and avoid 
giving enough to provoke another fit of coughing. 
Custards, broths, a little wine whey, an egg so soft 
that it can be swallowed as a liquid, and other 



2l6 COLDS, COUGHS AND SORE THROATS. 

articles of this character, must be used while the 
intensity of the disease remains, and as the cough- 
ing spells become fewer and farther apart, solider 
diet may be given. 

Of medicines directed to the cough, quinine, bella- 
donna, antipyrin and inhalations of chloroform are 
the most favored. Quinine may be given in the 
dose of one to one and a half grains for each year 
of the child's age up to five or six years, and this 
dose should be given three times a day, the first 
at six in the morning, the second at two in the 
afternoon and the third at ten at night. One or 
two grains of quinine dissolved in an ounce of 
water may be used as a spray, the nozzle of the 
atomizer being directed to all parts of the back of 
the mouth. It is believed that this treatment given 
to the other children of the household will prevent 
them from contracting the disease. It should be 
used every three or four hours. Hydrogen peroxide 
with an equal amount of glycerine and three or four 
times as much water, sprayed through the nose, 
is of benefit. The emulsion of asafoetida in the 
dose of a half teaspoonful every two hours is said 
to be very advantageous in relieving the coughing 
spells. 

Belladonna, antipyrin and chloroform should be 
used only under medical direction, as all are power- 
ful drugs and easily capable of doing harm. 
Chloroform is used by pouring a small quantity on 



WHOOPING COUGH. (PERTUSSIS.) 21 7 

the back of the hand and bringing the hand under 
the child's nose during the paroxysm of coughing, 
or immediately before it, if, as often happens, the 
child feels that the attack is coming on. It should 
never be given in any other way unless a doctor 
be present to direct the operation, and if chloroform 
is needed the doctor is, too. 

Owing to the severity of whooping cough itself, 
and the great danger of fatal complications, a physi- 
cian should invariably have charge of the case, 
and home treatment should only be resorted to as 
a matter of necessity. Fresh air and sunshine 
should be secured in abundance if possible, but get- 
ting damp or chilled must be most carefully guarded 
against. If the patient must be kept indoors, secure 
fresh air anyhow, and let it be moistened by croup 
kettle, tea kettle, or pails of boiling water renewed 
as they cease to steam. Use the bronchitis tent if 
necessary to keep an equable temperature (about 
70 degrees), and keep other children from the pa- 
tient until a week or two after the cough has ceased. 
Sometimes, however, the cough persists long after 
the disease is past, or it may return later on, being 
then known as '*the cough of habit.'' This cough, 
though sometimes very severe, is not considered 
dangerous, nor is there any risk of contagion. 



CHAPTER XVI. 
GENERAL TREATMENT. 
Constipation. Diarrhoea. 

While each of the different conditions included 
under the general heading ''Colds" has some dis- 
tinctive features of its own, yet some features are 
common to all, or nearly all forms, and in all forms 
require the same treatment both as regards medi- 
cine and the equally important matters of diet and 
general care. The treatment of these common 
features may well be grouped together, while the 
treatment that pertains only to particular ailments 
is appropriately considered in connection with the 
discussion of those particular ailments. 

As a rule, the first matter to be attended to in 
any form of cold or in any other disease, is the 
condition of the bowels, and constipation is such a 
constant attendant upon catarrhal inflammations 
(which are colds) that it is usually the point to 
which treatment should first be directed. It is al- 
most useless to attempt the removal of other disease 
conditions until this one is remedied. Not only 
does constipation interfere most seriously with the 
general nutrition, but poisons from the retained 

218 



CONSTIPATION. DIARRHOEA. 219 

waste matters are carried into the blood current, 
while the clogged and sodden condition of the ali- 
mentary canal prevents absorption either of neces- 
sary nutriment or of medicinal remedies. Or if 
partial absorption does occur, the hoped-for bene- 
ficial results are neutralized in great degree by 
poisonous materials already held in the blood. 
What may be considered by the patient himself a 
very slight degree of constipation may be abundant- 
ly sufficient to defeat all attempted measures of 
relief, hence the first effort must be to clear out 
waste matters and put the digestive tract into a 
condition of healthful activity. 

Since the world began there have been various 
and sundry ways of doing the same thing, hence 
if any reader knows a better mode of overcoming 
constipation than the one herein given, there is no 
reason he should not use it. The point aimed at 
is simply to restore a condition of wholesome activi- 
ty in the alimentary canal. For the following 
method, suffice it to say that it has been followed 
for generations by physicians and by private indi- 
viduals as well, with almost invariably good results. 

So soon, therefore, as a condition of disease is 
recognized in which constipation is a factor, begin 
the use of calomel in divided doses, followed after 
a proper interval by a dose of salts. Calomel pills, 
powders or tablets of any desired size and prepared 
by the best manufacturing chemists in. the world 



220 COLDS, COUGHS AND SORE THROATS. 

may be had of any good druggist. For an adult 
probably the best form is a compressed tablet con- 
taining from one-quarter to one-half grain of calo- 
mel and several times as much sodium bicarbonate, 
which is common baking soda, and aids the action 
of the calomel materially. Of these tablets, six 
should be taken, one at a dose, at intervals of from 
a half hour to an hour apart, the last dose being 
followed in three or four hours by a heaping table- 
spoonful of Epsom salts dissolved in a glass of warm 
water. If in three or four hours more the bowels 
do not move and move well, repeat the salts and 
continue to repeat every three or four hours until 
the proper action is produced. Rochelle salts or 
any of the effervescent saline laxatives, in corre- 
sponding dose, may be svibstituted for the Epsom 
salts if desired. With many people, a much smaller 
dose of the salts is amply sufficient. Whenever 
this is known to be the case, the smaller dose should 
be used. If the bowel evacuations are very dark, 
or much yellowness of the skin and whites of the 
eyes appears, or if the patient be robust and re- 
quires stronger dosage, a little podophyllin may 
well be added to the calomel and a tablet be used 
containing, say, one-quarter of a grain of calomel, 
one-twelfth grain of podophyllin and a little soda, 
six being used as before ; or give alternately a tablet 
of calomel and one of calomel and podophyllin 
combined. A very favorite mode in some of the 



CONSTIPATION. DIARRHOEA. 221 

country districts is to take the calomel powders 
or tablets an hour apart, arranging for the last dose 
to fall at bedtime, and then the salts are taken 
the first thing on awakening in the morning. 

After the bowels have moved well an intestinal 
antiseptic should be given. The special indications 
for their use are, first and most marked, an un- 
usually offensive odor to the evacuations, and of 
almost equal importance, flatulence, abdominal dis- 
tention, rumbling and painful movements in the 
bowels and a general sense of uneasiness in this 
region. These symptoms all point to undue mi- 
crobic activity, and the intestinal antiseptics destroy 
this excess of bacterial life and neutralize their un- 
wholesome products. When the evacuations become 
of normal odor and consistency and abdominal 
distension and uneasiness cease, it indicates that 
sufficient of the antiseptic medicine has been taken, 
and the doses may be decreased in size or be 
taken at greater intervals. Sodium sulphocarbolate 
(preferably Merck's preparation) is a favorite anti- 
septic with many physicians, moderate in price, not 
too disagreeable in taste and very effective. Five 
to ten grains, or roughly, what may be made to 
lie on a silver dime, is a fair adult dose, which 
should be taken every two hours for the first five 
or six doses, then three or four times a day, after 
meals and at bedtime, say, but the effect must be 
noted and dosage governed accordingly. In cases 



222 COLDS, COUGHS AND SORE THROATS. 

of tonsillitis and some other forms of sore throat, 
and where there is a rheumatic tendency, salol is 
an intestinal antiseptic which seems to be specially 
indicated and to have a peculiarly good effect. 
Salol can be bought in tablet form, and a five-grain 
tablet makes a good dose, to be taken at the same 
intervals as indicated for the sodium sulphocarbo- 
late. There are a number of good intestinal anti- 
septics put out by reliable manufacturers, with 
formulas and directions on the packages, all of 
which have the same effect of removing any excess 
of ill odor from the evacuations and of restoring 
them to proper consistency, also of relieving in- 
testinal distress and distension. 

The initial constipation being overcome, a proper 
freedom of the bowels must be maintained. At 
least one free evacuation from the bowels should 
be assured each twenty-four hours, and with many 
people, especially during sickness, two movements 
seem to be required. Too free purgation, how- 
ever, must be guarded against, as it is weakening, 
and in exhausting diseases, as la grippe or diph- 
theria, might easily become serious. 

Taking all things into consideration, cascara 
sagrada is probably the best known medicine for 
insuring proper freedom of the bowels. It rare- 
ly gripes, but moves the bowels easily and naturally. 
Far from inducing a drug habit, it is a genuine tonic, 
the necessary dose having to be gradually diminish- 



CONSTIPATION. DIARRHOEA, 223 

ed from the fact that the digestive organs are 
strengthened and toned up by its use. 

There is much Hberty of choice as to the cascara 
preparation to be used. It may be soHd or Hquid, 
of bitter taste or of pleasant flavor, a cordial, an 
extract, a tablet or a pill, and if prepared by a 
reliable firm the effect will be the same. To most 
people the tablet form will be the m.ore convenient, 
and three to five-grain tablets of the solid extract, 
plain, sugar or chocolate coated, are as handy as 
a pocket in a shirt. One to two of the three-grain 
tablets makes the usual dose for an adult, and a 
tablet can be cut up so as to make doses of any 
size. For an infant of one year, one of the three- 
grain tablets may be cut into twelve equal parts, 
one or two of which will make the proper dose. 
A good cascara cordial, however, is preferable for 
the little ones. The usual dose of the cordial is a 
half to a whole teaspoonful for an adult and from 
three to five drops for a one-year-old child. Most 
of the preparations give the proper doses for differ- 
ent ages on the label or wrapper. 

Having chosen the preparation, it is a matter 
of much importance to find the smallest dose that 
will produce the full effect desired. After this 
minimum quantity has been ascertained by careful 
and repeated trials, the dose should be kept at or 
near that point until its tonic effect allows a reduc- 
tion of the dose with equally good results. Suppose 



224 COLDS^ COUGHS AND SORE THROATS. 

the solid extract is chosen and a three-grain tablet 
is taken the first night. If the results are thoroughly 
satisfactory, consider that the proper dose. If one 
tablet is not sufficient, take a tablet and a half the 
next night; while if too active, try three-quarters 
or a half tablet, and so on until the proper dose 
is found. An hour or two after supper or on going 
to bed is the time usually selected for taking these 
medicines. If, on any particular day, a free bowel 
movement does not take place at the proper time, 
a small dose of salts may be given to help matters 
along, or, what is probably better under such con- 
ditions, an enema should be administered. Then 
the next dose of the regular laxative should be 
somewhat increased. 

There is a class of laxative or cathartic pills, 
consisting mainly, sometimes entirely of aloin, 
strychnine and belladonna, which have this same 
tonic effect on the digestive organs so that the dose 
may be gradually decreased and finally abolished. 
As they are very small, easily carried and easily 
taken, they may be preferred by those who are not 
ill enough to remain in bed, while others may find 
them better adapted to their individual wants than 
the cascara preparations. They are to be found in 
all drug stores and the formula with full directions 
for use is on each package. 

For children suffering with constipation it is often 
considered better to begin medication with a tea- 



CONSTIPATION. DIARRHOEA. 225 

Spoonful or two of castor oil, repeated in four 
or five hours if the first dose does not take effect, 
after which one of the cascara cordials is a very 
agreeable medicine to keep up free action of the 
bowels. Castor oil itself cannot be used for any 
length of time, as after the first cathartic effect, 
it has a decided tendency to cause constipation. 
For very small children, olive oil is a mild, safe 
and pleasant laxative, given in teaspoonful doses as 
often as may be necessary. It acts well with adults 
in the dose of a half ounce to an ounce. The com- 
pound licorice powder is another efficient child's 
laxative, and owing to its pleasant taste is very 
easily administered. From a quarter to a half tea- 
spoonful is usually sufficient. A small glycerine 
suppository, such as can be found in any drug store, 
often acts well with a child, or a suppository formed 
from a small piece of Castile, or other bland soap, 
will accomplish the same object. 

Very often constipation, whether in adults or 
children, is of mild type, only requiring one or two 
doses of some simple laxative to remedy the condi- 
tion. In such cases almost any of the remedies 
named are sufficient to give relief. The good old 
seidlitz powder is a favorite with many; others 
may prefer Epsom salts or some of the effervescent 
salines ; still others calomel followed by salts, and 
yet others a cascara tablet or a dose of one of the 
cascara cordials. 



226 COLDS, COUGHS AND SORE THROATS. 



f 



But suppose that diarrhoea rather than consti- 
pation is the trouble. Even here, in cases mild 
enough to justify home treatment, it is a good 
plan to commence treatment by a good big dose 
of castor oil, which often removes the cause of 
diarrhoea by sweeping irritating substances out of 
the intestines. Castor oil is chosen because, after 
its primary cathartic effect, it is constipating, and 
if for an adult a drop or two of laudanum be 
added to the dose, it aids the effect and also checks 
griping, to which castor oil is prone. If diarrhoea 
still persists, teaspoonful doses of blackberry brandy 
or of blackberry cordial given after each movement 
of the bowels will usually end it very quickly, and 
care is necessary lest too much be given and the 
opposite condition be induced. When no source 
of bowel irritation exists, paregoric will usually 
check any mild case of diarrhoea. One to two 
drops is a sufficient dose for an infant, five or ten 
drops for an older child, say up to ten years of age, 
and a teaspoonful or two for an adult. While the 
use of paregoric or any other compound of opium 
to quiet fretfulness or put a child to sleep cannot 
be too strongly condemned, its careful use in the 
treatment of diarrhoea is perfectly admissible. 



CHAPTER XVII. 

GENERAL TREATMENT. 

Fever. 

Fever, in greater or less degree, is a symptom of 
so much frequency in the first stages of acute res- 
piratory diseases, that a few words as to its home 
treatment will not be out of place. 

As fever is characterized by high temperature, 
hot, dry skin, and much thirst, it would seem no 
more than ordinary common sense to combat it 
with low temperature, cool or cold applications to 
the external body and plenty of cool water to drink, 
and, guarding against the excessive or improper 
use of these remedies, the deduction is strictly cor- 
rect. 

Strange as it may appear, for long, long years 
this most rational and natural method of meeting 
fever was considered wholly wrong, and there is 
no doubt that many thousands of fever patients 
died in the horrible torments of thirst, while the few 
drops of cold water that would have eased their 
sufferings and saved their lives were refused them, 
in some instances even snatched from their eager 
hands by their dearest friends, acting, ^ as they be- 



228 COLDS^ COUGHS AND SORE THROATS. 

lieved, under the soundest medical advice. It is 
pleasant to record the fact that in a number of cases 
some fond, weak mother or silly, affectionate old 
colored aunty, or other relative or acquaintance, 
unable to bear the sight of such keen and easily 
alleviated suffering, secretly supplied the forbidden 
fluid and saved the patient's life. In other cases 
water was stealthily obtained by the patient him- 
self, and in yet others some cross-grained, hard- 
headed old sinner refused to sacrifice common sense 
to the dictum of medical science and obstinately in- 
sisted that a thirsty man must drink, so again the 
torture ended and the victim lived. Finally such 
a mass of evidence accumulated along these lines 
that so-called science had to give way to facts, and 
water was no longer an unattainable luxury to those 
who needed it most. 

How often, then, should a fever patient be given 
water? As often as he asks for it. In some cases, 
indeed, as where a patient lies in apathy or stupor, 
not realizing either hunger or thirst, it must be 
given as a matter of routine, just as food is given 
in such conditions. Sometimes a fever patient will 
call almost ceaselessly for cold water and drink it 
in huge gulps if allowed, but this is so easily reme- 
died that it is only mentioned in passing. Large 
draughts of very cold water may do much harm, 
but small and frequent drinks will not, and these 
should be given whenever asked for. The colder 



FEVER. 229 

the water the smaller the quantity at one time, and 
in case of a peevish child who seems to be calling 
for water more as an expression of fretfulness than 
from real need, a teaspoonful at a time will often 
satisfy as quickly as if tumblerfuls were given. For 
adults and children old enough to refrain from 
swallowing it, small lumps of ice held in the mouth 
and sucked or allowed to dissolve, will sometimes 
relieve more quickly and completely than a much 
greater quantity of water. Sponging arms, face 
and chest with cool or cold water often reduces 
thirst to a considerable degree, and a towel wrung 
out of cold water and applied to the forehead, re- 
newed as it becomes warm, will markedly alleviate 
a feverish headache and favorably influence the 
fever itself. A few good sour lemon drops to a 
child, or ice cold lemonade to child or adult, sipped, 
not gulped, will often prove refreshing and grate- 
ful. When the throat is persistently dry and the 
tongue parched, glycerine and water in equal parts 
make a cleansing and refreshing mouth wash and 
gargle, and if the teeth and gums are rubbed with 
a soft cloth moistened with this mixture it will keep 
the mouth in far better shape and the breath from 
foulness to some degree. A little lemon juice added 
to the above mixture is an improvement. In this 
condition, also, the homely expedients of chewing 
gum, slippery elm bark and kindred substances often 
■give marked relief. 



230 COLDS^ COUGHS AND SORE THROATS. 

Usually when water is spoken of as a fever 
remedy, its external use is intended, and here it is 
indeed ''A helper in the time of need/' When the 
temperature gets into the neighborhood of the dan- 
ger point, say above 105 degrees, cold water is the 
one reliable remedy, and even where the fever may 
be controlled by drugs it is as certainly combated 
by this every-day necessity. 

One point should never be overlooked ; whenever 
the entire body, or a large part of it, has the tem- 
perature suddenly reduced, as by the use of cold 
water, it should be immediately followed by ener- 
getic friction, as rubbing with a coarse towel or its 
equivalent, until the skin is again brought to a 
healthful glow. In cases of fevered headache with 
congested eyes that seem to burn in their sockets, 
and also in the highly inflamed joints of acute 
articular rheumatism, cold water may be applied 
by means of a compress (a towel or similar article 
folded to proper size) wrung out of cold water and 
constantly renewed as it becomes warm, and no 
subsequent rubbing is considered necessary, but 
these are limited areas, and sudden chilling of any 
large portion must be quickly succeeded by vigorous 
rubbing to restore the normal tone. The rubbing 
is perhaps the more necessary part of the bath, as 
the cold water drives the blood to the internal parts 
that receive no such cooling application, and the 
circulation must be restored to the external parts 



FEVER. 231 

and the reduction of temperature equalized if we 
expect the best results. 

Suppose the patient is too weak to render it ad- 
visable for him to leave the bed or himself under- 
take the bath, what then? Take a basin or pail of 
cold water, as cold as he can stand it without dis- 
comfort, and with a sponge or towel, not wet enough 
to allow water to drop or run about, but damp 
enough to insure water coming into contact with 
every part of the body subjected to its action, go 
over the arms, chest, neck and front of the body, 
rubbing with a dry towel as each part is bathed until 
the skin is again normally warm and in a healthful 
glow. Then, rolling him gently over, repeat the 
process on the remainder of the body. Give at least 
twice the amount of bathing along the back that 
the rest of the body receives with a corresponding 
amount of towel work afterwards, in order that the 
large muscles, thick skin and deep-seated blood ves- 
sels found in this location may have a fair share of 
the beneficial process. After bringing the skin to 
the required warmth and glow, the patient will 
enjoy a season of comparative rest and comfort 
and very likely a refreshing sleep. If only the arms 
and along the spine can be attended to in this fash- 
ion at one time, it is so much to the good, and other 
parts can be bathed at another time. 

If a patient is too weak or too delicate to stand 
cool or cold water he may be sponged^ with luke- 



232 COLDS^ COUGHS AND SORE THROATS. 

warm water, or better, water and alcohol in equal 
parts, and as in this case there is little chilling the 
vigorous rubbing is not necessary. This is a splen- 
did form of bath when the patient is restless, fever- 
ish and cannot sleep, and will often secure an entire 
night's refreshing slumber. Lukewarm water and 
alcohol in equal parts also makes the proper bath 
for a fevered baby, but if alcohol cannot be obtained 
the water must needs answer, or it may have a little 
salt dissolved in it. 

Sweet spirits of niter (spiritus setheris nitrosi) 
is one of the safest medicinal remedies for fever, 
but is nevertheless of great value. For adults a 
half or even a whole teaspoonful at a dose is not 
too much. It should be given in hot water or 
lemonade, and the patient kept warmly covered 
until perspiration occurs. If necessary the dose 
may be repeated in two or three hours until the 
fever is broken up. For a child of one year, three 
or four drops may be given in cool water and re- 
peated every two or three hours while the fever 
lasts. A favorite method of administration to 
children in country neighborhoods is to put ten 
drops in a tumblerful of water and give a teaspoon- 
ful every hour. Even this small dose proves bene- 
ficial, and when a good dose of castor oil is also 
administered a mild fever often yields. 

Among medicinal remedies for fever probably 
nothing compares with aconite, but it requires con- 



FEVER. 233 

siderable medical knowledge for its proper use and 
should not be handled unless thoroughly understood. 

'Tever powders/' as too often used in the house- 
hold, are a thousand times more dangerous than 
aconite, and untold harm is done by their injudi- 
cious administration. That they will ordinarily re- 
duce fever quickly and completely is undoubtedly 
true; that they may and often do kill the patient 
is every whit as certain, and their home use, merely 
to allay fever and restlessness and without any 
knowledge of their further action, cannot be too 
strongly condemned. The drugs of which they are 
usually composed are valuable medicines if rightly 
used; otherwise a tame rattlesnake is a far safer 
and less objectionable adjunct to the sick room. 

A cool, well ventilated room is a necessity in 
fever, and though drafts or much wind must be 
avoided, the more fresh air the better. In summer 
time, or at other times if temperature allows, a 
tent with the sides raised so as to admit a great 
abundance of fresh air while shielding from winds 
and too much sunshine, is the best possible arrange- 
ment. 

Warm and stuffy bedding is to be avoided. A 
feather bed is an abomination. The mattress should 
be neither hard nor soft, and the pillows for the 
head rather hard, while several soft, light pillows 
to place about in such wise as to support the weight 
of different parts of the body in different postures 



234 COLDS, COUGHS AND SORE THROATS. 

add much to rest and comfort. The best coverings 
are thin, Hght blankets, with heavier coverings to 
be used when a tent is occupied and nights are cold. 
Diet rules in fever are much the same as in all 
disease ; very little and that liquid at the start, and 
from that grade up to solid food again as recovery 
progresses. Slow or protracted fevers form an ex- 
ception. In these food must often be given when 
appetite is absent, and much care and skill are need- 
ed to adapt diet to the needs of the case, to aid 
digestion and to conserve and increase the patient's 
strength. 



PART III.— Hygiene. 



CHAPTER XVni. 
Fresh Air and Sunshine. 

That a few chapters on hygiene, or the science 
of health, should be included in a work on colds, 
coughs and sore throats, needs no apology and but 
little explanation. The most satisfactory and abso- 
lute preventive of all diseases of this character is a 
good strong constitution, and a continued condition 
of good health, such as is only attainable by con- 
formity to the rules of hygiene. 

The value of good health is universally recog- 
nized. A thoroughly healthy man or woman can 
hardly be unhappy ; a thoroughly unhealthy one can 
hardly be happy under any conditions. And health 
is largely a matter that is in our own keeping. The 
world was made for man to live in, and all things 
necessary for healthful living are furnished in 
abundance. It is our place to know how to obtain 
and properly use what has already been created for 
that especial purpose. 

Hygiene, the science of the care and preservation 

235 



236 COLDS, COUGHS AND SORE THROATS. 

of the health, should be properly taught in every 
primary school. More than that, it should be 
taught in the home before the child is old enough 
to go to school. Every man, woman and child 
should have at least a general knowledge of the 
laws of health, and how to apply them. Houses, 
schools, factories, offices, and all other buildings 
intended for the use of men, should be constructed 
with due regard for healthfulness. Food should be 
chosen and prepared with a view to obtaining health 
and strength from its use, and in all things, the 
vitally important matter of health should be taken 
into consideration. 

As things are, hygiene, often of a very poor and 
impracticable brand, is taught in a small percentage 
of the primary schools. In the home, very fre- 
quently, it is not taught at all. Most of our Ameri- 
can citizens do know enough to come in out of the 
rain, but many of them do not know enough to go 
out into the fresh air and sunshine. Houses are 
built to hold the greatest number of people in the 
smallest amount of space, and in the cities, build- 
ings intended for homes so crowd each other that 
a small dooryard is a luxury, while a dwelling house 
with free access of air on every side marks the 
residence of a man of wealth. If clothing *'looks 
weir' on a man, or is ''pretty'' on a woman, it 
fulfills its mission, and food is procured to tempt the 
appetite rather than to minister to health and 
strength. 



FRESH AIR AND SUNSHINE. 237 

Lest this picture seem too gloomy, let us add 
that matters in regard to hygiene are in far better 
condition now than fifty years ago. At this present 
time more attention is given to healthfulness than 
at any previous period of our history, and, in this 
respect at least, the world is steadily growing better. 

Two of the prime requisites of healthful living 
are fresh air and sunshine. Nature furnishes them 
in inexhaustible abundance, yet thousands pine and 
die and countless millions suffer for want of their 
own small share of the unlimited oceans of sunshine 
and fresh air that are all around us. The history 
of many a noisome dungeon cell bears silent wit- 
ness to the fact that life can be maintained for long 
years without these necessities, but healthful human 
life is not possible under such conditions for any 
time at all. A human being ought to have pure, 
fresh air during twenty-four hours of every day he 
lives. If it is out of his power to have fresh air 
for twenty-four hours, then let him have it for as 
many hours as it is possible. If, as is the case 
with many who dwell in cities, fresh air is only a 
comparative term, and the choice is between pollu- 
ted air and air less polluted, that which is less 
objectionable should be chosen for just as large a 
proportion of the time as circumstances will allow. 

A very important point, and one that is by far 
too frequently neglected, is to get the full benefit 
of what air is at our disposal. If the shoulders 



238 COLDS, COUGHS AND SORE THROATS. 

droop and the chest is narrow and contracted, the 
lung capacity is necessarily less than Nature intend- 
ed, arid vigorous physical life becomes, to most of 
us, an impossibility. An upright bodily carriage, 
and well developed chests and lungs, are not as yet 
among our national characteristics. 

The right time to establish correct habits in this 
respect is during the growing years of childhood 
and youth, and there are few points in the training 
of young people that deserve more attention than 
this. Let the child be taught to sit and stand erect, 
and to breathe deeply and fully, expanding the lungs 
properly and thoroughly oxygenating the blood. 
Encourage the healthful sports of childhood and 
youth that tend to such habits ; also the breathing 
exercises and calisthenics that are fortunately in- 
cluded in the curriculum of many of the lower 
grade schools. All teachers, from those of primary 
grades to college professors should understand this 
matter fully, make a point of proper bodily carriage, 
and reprove for unhealthful and slouchy positions of 
the body more promptly than for failure in recita- 
tions. If any child, or older student of either sex, 
is really too weak to hold the body properly erect, 
that one is surely too weak to be confined in the 
school room at all. The long hours of labor in 
factories and kindred institutions to which some 
children are subjected are a blot upon civilization 
and cannot l)e reprehended too strongly. Correct 



FRESH AIR AND SUNSHINE. 239 

physical development is an impossibility under such 
conditions, and the only remedy is to put a stop 
to all such abuses by the strong arm of the law, 
reinforced by the vastly more potent force of in- 
dignant public opinion. 

But even grown people, and those well advanced 
in years, can do much to aid Nature. Regular 
periods of deep, full breathing, indulged in once or 
twice daily, will increase the chest capacity and do 
much to establish better habits of breathing all 
through the day, and it is never too late to make 
some improvement in the carriage and habitual 
position of the body. 

Dwellers in the country can, as a rule, secure 
pure, fresh air in abundance. They are, however, 
great sinners in the matter of closed bedroom win- 
dows. Why any one should wish to shut out 
healthful, sweet and wholesome air, and sleep un- 
easily in a polluted atmosphere is a puzzle for 
the psychologists; it is too much for the medical 
men. The old superstition that night air is poison- 
ous may have something to do with it, or it may 
date back to days when the powers of evil were 
believed to prowl at night and to find open windows 
more convenient than key holes. If any one really 
dreads the night air, let him experiment with a 
small quantity, lowering a window from the top 
ever so slightly at first, and gradually allowing 
more fresh air to enter as he finds it not only harm- 



240 COLDS, COUGHS AND SORE THROATS. 

less but wholesome and very pleasant. Or if drafts 
be feared, slip a small plank beneath the bottom 
sash of each window, thus separating the sashes 
and allowing a certain amount of fresh air to enter 
without the possibility of a draft. Or, what is 
still better, have a false sash, in which some light 
cloth replaces the glass, made to fill at least one- 
fourth of the window space, and raise the lower 
sash to give the false one place. Either of these 
devices may be used for ventilation during the day- 
time, and are especially useful in cold weather or 
in dusty localities. 

On rising in the morning it is always a good 
plan to set every door and window of the sleeping 
room widely open, for a few minutes at any rate. 
This usually secures a complete change of air and 
freshens things up wonderfully. And if any' of 
our lady friends wish to keep a few flowers in 
the sleeping room, do not let any idea that such is 
an unhealthful procedure deter them from it. The 
contrary is rather the case. 

Women in the country suffer from poor venti- 
lation and bad air much more than the men. Their 
work is largely indoors, and country houses are 
sometimes far from perfect as regards ventilation 
and the sanitary condition of their surroundings. 
In building new houses in the farming country, the 
opportunity to secure proper ventilation and satis- 
factory sanitary conditions is too good to be lost. 



FRESH AIR AND SUNSHINE. 24I 

Under such circumstances these objects should 
never be lost sight of. 

Houses already constructed can often be made 
much brighter and more wholesome by slight alter- 
ations. Perhaps one or two extra windows will 
admit a flood of sunlight and an abundance of fresh 
air to some room or rooms that have heretofore 
been close and dark. Or a porch may be added 
to the house, making a delightful open-air place for 
the performance of much of the work of the house- 
hold. Of course unsanitary surroundings should be 
modified as thoroughly as possible wherever they 
exist. A little ditching may drain some unhealthful 
pool of standing water. Considerable labor and 
much drain pipe can be very profitably expended in 
rendering a damp, musty cellar dry and sweet. 
Ill-smelling swill pails can be replaced by galvan- 
ized iron pails, emptied and scalded often enough 
to keep them reasonably clean, and a small, easily 
constructed trough will carry the drip from the well 
spout and prevent an unsightly and unsanitary pud- 
dle at that point. 

Then, about the barns and stables, a small amount 
of work will often make a wonderful difference in 
cleanliness and purity. The too common foul-odor- 
ed, muddy hog pen should not be tolerated one day 
longer than will suffice to replace it. Plenty of 
yard room and a shed with boarded floor and straw 
or waste hay for bedding for the pigs will pay 



242 COLDS, COUGHS AND SORE THROATS. 

many times their cost in healthfulness to the entire 
neighborhood, and in the thrift of the animals 
themselves. That horses and cattle should be forced 
to stand and sleep in filth is a disgrace, even to our 
very imperfect civilization. Not only does it give 
rise to unhealthful conditions in a place where much 
of the daily work must be performed, but where 
the family or neighborhood supply of milk comes 
from cows so stabled, the farmer, his family and 
his customers will infallibly swallow a portion of 
the stall contents. 

Of sunshine, the men of the farm often get en- 
tirely too much ; the women, sometimes a sufficiency. 
To work hard for from ten to fourteen hours a 
day, exposed to the burning sun for the larger 
part of a July day is a severe trial to the strongest 
man. The negro farmers who work in the early 
morning, sleep or loaf through the hottest part of 
the day, and then work through the evening, and 
in some cases well into the night, show a better 
appreciation of their environment than the thrifty 
white man, who perhaps loses several weeks of the 
busiest season from sunstroke or some fevered con- 
dition brought on by overmuch exposure. 

But the heat in many a farm kitchen is worse 
in summer time than that of the hottest field. Fre- 
quently it is the hottest part of the house, even 
without the fire, and in the warmer portion of the 
year becomes simply unendurable. A summer 



FRESH AIR AND SUNSHINE. 243 

kitchen, entirely separate from the main house, 
thoroughly ventilated, and if possible, set in the 
shade of trees, will often give the farmer's wife 
a new lease of life, while some farmers' wives have 
simply put their stoves and cooking utensils under 
the trees in summer, with no other protection. This 
is far better than remaining indoors, but it is ad- 
visable to have some sort of roof or canopy in case 
of rain. 

It is a great pity that the benefits of tent life are 
not more appreciated and enjoyed by those who 
have an opportunity for such luxuries. Where an 
old fashioned house with few and small windows 
will be close and stuffy in spite of all available 
ventilation, a tent will give cool, refreshing slumber, 
and, during the day time, with sides raised, will 
make an almost ideal place for sewing, preparing 
meals, and a number of household duties, too often 
performed in close, hot quarters. 

The fact that many an invalid has entered upon 
a rapid and permanent convalescence immediately 
after exchanging a bed room for a tent, proves 
conclusively its healthfulness. But in fine weather, 
where good shade trees are available, no tent is 
needed. A table or two, a few chairs, a set of 
shelves or a locker or two to accommodate the 
arrangements for domestic work, offer fresh air 
advantages that can hardly be surpassed, and the 
tiniest toddlers can play about in the fullest enjoy- 



244 COLDS^ COUGHS AND SORE THROATS. 

ment of out-of-doors life, and yet be under the 
mother's watchful care while she performs her 
household duties. 

If trees do not already grow about the house, 
they should certainly be planted. Those of rapid 
growth will yield shade enough for much enjoy- 
ment in the course of a very few years, and slower 
growing varieties can gradually add their propor- 
tion of comfort and beauty. If, on the other hand, 
trees and shrubbery so encompass the house that 
sunlight and fresh air are largely excluded, a part 
should certainly be removed. It is far easier to 
cut down a tree or shrub than to grow one, but 
that furnishes no valid reason for allowing the 
home to stand in what is practically a gloomy 
thicket, as is sometimes the case. 

That abomination of modern civilization, the 
combined bath room and water closet, supplying the 
only facilities of the kind, cannot be too severely 
condemned. Where other closet arrangements are 
accessible to every one in the house there are no 
objections to such a room, but only under such 
circumstances should it be tolerated at all. There 
are certain necessary functions of physical life that 
must be attended to promptly when need arises, 
and if through lack of conveniences they are post- 
poned for varying and indefinite periods of time, 
it is surely at the expense of health and comfort. 

Notwithstanding this fact, the convenience of hot 



FRESH AIR AND SUNSHINE. 245 

and cold water at will, and the good, large, auto- 
matically emptying tub of the bath room is some- 
times too great for a busy female to resist, and such 
an one will carry through a good sized washing 
in this place, taking perhaps several consecutive 
hours for its completion. Usually in a household 
where this occurs there are no other toilet accom- 
modations and the proper uses of the bath room 
are suspended meanwhile. Or perhaps some self- 
indulgent member of the family will occupy it for 
nearly as long a time in an indolently luxurious 
bath. Frequently it is used by the men of the 
household for a shaving parlor and general dress- 
ing room, and the children in a crowded boarding 
house will not seldom hold the bath room each for 
the other until every mother's son (and daughter) 
of them all has had the weekly bath. No comment 
is necessary. 

The closet arrangements found in the country are 
''just tolable'' — neither very good nor yet very bad. 
Very often they can be made vastly better by a 
little thought and exertion. They should always 
be set well away from the water supply, and an 
excavation is not an essential. An abundance of 
dry road dust, sifted ashes or other absorbent ma- 
terial should be kept at hand, and by its regular 
and liberal use the contents of the closet can be 
kept odorless and dry, and in this condition can be 
easily hauled off to some field or out-lot at proper 
intervals. 



246 COLDS, COUGHS AND SORE THROATS. 

A bath room, or at least a room that can be used 
for bathing purposes, should be an adjunct to every 
house, whether in the city or country. Where the 
usual bath room is not possible a small room can 
be set aside for this purpose, and yet remain of 
much use for other purposes. In the country a 
separate building, large enough for this purpose, 
can be erected at small cost. It should contain a 
stove, kettle or other device for heating water, a 
set of shelves or other arrangement for clothing, 
towels, etc., and as large and convenient a tub as 
circumstances allow. 

In the cities the problem of securing fresh air 
and sunshine is a vastly more complex one than it 
is in the country. Parks for grown people and 
babies are, however, far more plentiful than they 
were forty years ago. And the younger people of 
both sexes boat and bathe, play golf, bicycle and 
in various other ways secure out-of-doors exercise, 
with its accompaniments of fresh air and sunshine. 
Suburban homes are more plentiful than ever before 
and steady improvement in transportation facilities 
causes corresponding increase of this mode of life. 
Summer vacations are a rule in modern life to an 
extent unheard of forty years ago, and all along 
the line there is a tendency to appreciate and enjoy 
these out-of-doors advantages that bodes well for 
the future. 

The huddling together of city dwellings is an 



FRESH AIR AND SUNSHINE. 247 

evil of great magnitude and one that will be hard 
to overcome. ''God made the country, man the 
town/' shows forth in this respect most glaringly. 
Until our entire population is educated to an extent 
as yet undreamed of, houses will probably be built 
chock-a-block, human beings will continue to occupy 
den-like rooms, and the problem of sufficient sun- 
shine and fresh air will continue to be the hardest 
that confronts the inhabitant of a city. And to each 
of you, ye poor cooped up dwellers in the cells 
of civilization, the problem becomes a personal one. 
Each individual must secure for himself and for 
those dependent on him as much of the wonderful 
blessings of sunlight and fresh air as circumstances 
allow and his knowledge of their importance de- 
mands. 

Whenever practicable the city worker should se- 
cure a suburban home. For you to whom the sub- 
urban life is an impossibility — window ventilation 
of offices and bed rooms, a rustic seat in the hand's- 
breadth dooryard, a stroll on the street or in a city 
park, occasional outings and excursions, and what- 
ever vacation can be secured, spent in the most 
healthful country you can get to — these and what- 
ever else of out-of-door advantages you are able 
to obtain, must satisfy your soul, and may health 
and good fortune attend you in spite of your lack 
of the best that life can of¥er. 



CHAPTER XIX. 
The Food We Eat. 

Of the different varieties of food, we need at least 
four. Breadstuffs, meats, vegetables and fruits 
should all enter into a healthful and well regulated 
diet. Eggs, milk, butter and cheese would of course 
come into such a list under the heading of meats. 
As to the best articles of diet for each individual, 
and likewise as to the quantities that should be 
eaten, each individual must be himself the judge. 
No person with a reasonable degree of intelligence 
can fail to note the fact that certain foods agree 
with him better than others. Carry this sort • of 
observation further so that you will find out defi- 
nitely all along the line what articles give best re- 
sults in health and strength, and then apply the 
facts so ascertained to the selection and use of food 
stuffs, and no book or scientist in the world can give 
you one-half as good directions as you can formu- 
late for yourself. 

For children, of course, the parents should exer- 
cise this care and judgment. The young of the 
human race are more directly under their parents' 
observation and guidance than is the case with any 
other kind of animal, and it is self evident that on 

248 



THE FOOD WE EAT. 249 

the parents falls the responsibility until the children 
arrive at years of discretion. 

A few general principles, however, can be laid 
down. The man who is performing hard physical 
labor requires more and heartier food than he 
whose work is at a desk, and his digestion is 
correspondingly more active. The man who sits 
at a desk for from six to eight hours a day must 
choose a lighter and more easily digestible diet than 
his sturdier brother of the fields or woods, and even 
then he must take some amount of vigorous exer- 
cise if he wishes to maintain any degree of health. 

Growing children, like all other young animals, 
take much exercise and never lack for appetite. 
A little food midway between meals is not likely 
to hurt the healthy child, especially if it be of simple 
character, as a slice of bread and butter. As much 
cannot, however, be said of the continual ^^piecing'' 
in which some children are indulged, which cannot 
fail to be harmful, especially when the food so 
eaten between meals consists mainly of sweetmeats, 
cakes, pickles, or other somewhat doubtful articles, 
as is frequently the case. Milk is a grand article 
of diet for growing children and one that they 
usually appreciate. Good wheat bread with butter 
is also a standard, and continues to be so all through 
life. Corn bread and corn meal mush, oatmeal once 
in a while, and the various excellent breakfast 
foods, give abundant variety in breadstuffs. 



250 COLDS, COUGHS AND SORE THROATS. 

Of meats growing children should not eat too 
heavily, and they are better off without coffee or 
tea. Vegetables they should have in plenty, and 
fruit should always be at command. Throughout 
the summer time fresh fruits of whatever varieties 
are in season should be supplied them. In winter 
baked apples with a little cream is one of the best 
fruit dishes, though many others are excellent. 
The child's taste should not be totally disregarded, 
neither should too much weight be given to whim- 
sical fancies. If a child manifests a strong and 
persistent aversion to any particular article of food 
it is downright cruelty to force it on him, and may 
have harmful results. 

There is an old but a good story of a small boy 
whose kind old aunt, under the idea of proper train- 
ing, forced him to eat whatever he particularly dis- 
liked. She explained that he might be where such 
articles were on the table and it would be impolite to 
refuse them. One morning on turning her plate over 
she was horrified to discover a small dead mouse. 
In reply to her indignant demand for an explana- 
tion, the small boy gravely responded that she might 
some day find herself in China, where, as both of 
them devoutly believed, dead rats and mice were 
eaten raw, and therefore she should accustom her- 
self to this form of dainty. Whether the good lady 
had sense enough to make the application the story 
does not record, but it is to be hoped she saw the 



THE FOOD WE EAT. 25 1 

point and respected the child's prejudices to a rea- 
sonable extent thereafter. Children are so thor- 
oughly under the care and constant notice of their 
parents that if watchful and intelligent observation 
is given in regard to diet, it would seem impossible 
to err to any great extent. Their food should be 
simple, nourishing and appetizing. Further than 
that, the individual peculiarities and needs of the 
child should determine the character of his food. 
Healthful children, enjoying plenty of out-of-doors 
exercise, are not usually hard to suit, and it is worth 
much trouble to insure them healthful food. 

With grown people, occupation is one of the 
greatest determining factors as to the character of 
their diet. An office worker may find a cup of 
coffee, or some substitute therefor if he chooses, 
a dish of any one of the excellent breakfast foods, 
with cream or rich milk, an egg and a small slice 
of bacon, an abundance. The man who chopped 
a cord of wood yesterday and expects to do still 
better today will want two or three cups of coffee 
(better if he drank milk), considerably more of 
meat, plenty of good wheat or corn bread with 
butter, and a plate of potatoes. 

There is enough of food and enough of variety 
to suit every taste and every need, but each indi- 
vidual must be the judge of what and how much 
is proper for his own individual requirements. A 
little intelligent observation will soon put a man 



252 COLDS, COUGHS AND SORE THROATS. 

on the right track, and continuance of the same 
process will enable him to eat for health and 
strength with a fair measure of success. 

There is, however, in modern civilization, a great 
tendency to multiply dishes — to serve a dozen or 
more different foods at a single meal, sometimes 
thereby disguising poor quality and poor cooking 
by multiplicity of tastes and flavors. Bread, and 
if desired some other form of cereal food, good 
butter, one kind of good meat, one or two vege- 
tables and one simple dessert — is not this enough 
for any man in a dozen dukedoms ? 

The quality of the food we eat is a matter of 
considerable importance. Go to the public markets 
in any large city, and note the meat there exposed 
for sale. Some is first rate, firm in texture, bright 
in color, odorless, or but faintly so, and generally 
pleasing in appearance. Much is far from first rate, 
loose in texture, flabby to the touch, pale or purplish 
in color, and not infrequently offensive to the nos- 
trils. Yet somebody eats it. Poultry is often worse. 
The custom of putting poultry and game in cold 
storage without removing the entrails results in 
a food article that is properly described as disgust- 
ing. Fortunately this custom is prohibited by law 
in some of our cities, but it ought to be put down 
everywhere by force of public opinion. Fruit and 
vegetables generally make a better showing in the 
markets. Much, how^ever, is exposed that is hardly 



THE FOOD WE EAT. 253 

fit for human use. Nevertheless these articles are 
sold and presumably eaten. 

Even if food is secured that is good in the raw- 
state, it may be ruined in the cooking. The best 
roast that ever graced a butcher's stall may come 
on the table fit only for the dogs, and the same is 
true of all other food articles. Every mother should 
educate her daughters to choose food articles with 
good judgm.ent and to cook or otherwise prepare 
them properly. Her daughters may not have to 
cook, but they will know how, and the knowledge 
will not come amiss. And every man should so 
educate himself that he may purchase meat, game, 
poultry, fruit or vegetables of such quality that he 
need not be ashamed of them when they appear 
at the table, for on the good man of the house- 
hold the purchasing very often and very properly 
falls. 

There is a popular idea that all of us habitually 
eat too much. This is much of a fallacy. Some 
there may be who are gross and gluttonous feeders, 
but they are a small minority and are generally 
well acquainted with their own failing. Most of 
us do not eat too much, but, among the indoor 
people at least, many do take too little exercise and 
suffer from indigestion accordingly. A certain 
amount of active physical exercise, taken daily, is 
a requisite with all of us if we wish to enjoy good 
health. Man was not formed to sit at a desk 



254 COLDS^ COUGHS AND SORE THROATS. 

through the business hours of each day and spend 
the rest of the time in idleness or sedentary pleasure. 
We are animals, cultivate the mind and neglect the 
body as much as we may, and animal life invariably 
calls for a certain amount of physical exertion. If 
this fact is neglected, all the dieting in the world 
will not result in good health, but if a proper 
amount of exercise is taken, moderate eating is 
enjoyable and healthful. In this matter, as in diet- 
ing, each individual must find out his own needs, 
noting what amount of exercise is requisite for 
healthful life, and governing himself accordingly. 

In changing from a vigorous physical life to one 
of more sedentary character, the appetite, however, 
often demands enough for the active life, while the 
digestion can only take care of what is needed 
under the new regime. The usual illustration of 
this chain of circumstances is the young man going 
from the harvest field to the college. The habitual 
amount of nourishment is taken, the habitual 
amount of exercise is neglected. Naturally the 
youth becomes bilious and suffers with various 
digestive troubles. It generally results in a doctor 
being summoned, who gives the young man a good 
dose of physic and an equally good dose of advice, 
and the young man recovers and goes on his way, 
a wiser, but not necessarily sadder man. 

Ordinarily, if we eat simple, wholesome food, 
in such amount as our occupation and habits de- 



THE FOOD WE EAT. 255 

mand, and take a reasonable amount of exercise, 
the appetite is a very reliable guide. Reason, how- 
ever, must superintend the whole business, both as 
to quantity and quality of food and the requisite 
degree of daily exercise, and each reasonable indi- 
vidual must recognize these facts, accept the re- 
sponsibility for his own health and govern his life 
accordingly. 



CHAPTER XX. 
Exercise. 

At the present day the fact is very generally 
recognized that bodily exercise is an absolute neces- 
sity for the maintenance of a proper degree of 
health. A state of complete inactivity would soon 
result in atrophy, or wasting of the muscles, and 
a general failure of physical health. This wasting 
of the muscles is well shown in paralysis, where 
the parts affected shrink away to little more than 
skin and bone. Also in the condition of a broken 
limb after enforced inactivity during the process 
of repair. 

The greater physical development and more ro- 
bust health of those people who make up the labor- 
ing classes, as compared with clerks and office em- 
ployees, is a matter of daily observation. This 
difference, however, is less marked than twenty 
years ago, and is continually becoming less notice- 
able as the benefits of regular and systematic exer- 
cise are more fully appreciated. 

But, while all intelligent persons recognize the 
necessity of physical exercise, many take but a 
minimum thereof, and far too little to keep the body 

256 



EXERCISE. 257 

in good working order. There are various causes 
for this condition of affairs. Some do not take 
exercise because of sheer laziness. Some lack facili- 
ties, or, having the facilities, do not quite know 
how to take advantage of them. Others are physi- 
cally weak and can barely summon up enough 
energy to crawl wearily through their daily tasks. 
Still others are discouraged with life generally, and 
have given up all hope of ever bettering their con- 
dition, either physically, mentally, morally or finan- 
cially. 

On the other hand, among the laboring classes, 
those who literally ''Eat their bread in the sweat 
of their brows," many really get more exercise than 
is necessary for health. But even these sturdy 
brethren can do much to improve their bodily con- 
dition. If any among them will make the erect 
bodily position habitual, and also acquire the habit 
of breathing deeply and fully, their physical im- 
provement will be marked and gratifying. Because 
a man stoops over the plow handles for ten or 
twelve hours a day during forty or more days of 
the year, is it any reason that he should stoop for 
the remaining three hundred and twenty-five days ? 
Or is it really necessary that he should stoop at all ? 
Indeed many kinds of physical labor can be made 
to favor correct position and proper breathing. 
Chopping wood requires the fullest expansion of the 
chest, and many other kinds of work can be made 



258 COLDS, COUGHS AND SORE THROATS. 

helpful in this respect if attention is given to the 
matter. And, in the present day, when so many of 
the more laborious processes, especially in farming, 
are carried on by horses or steam power, is there 
any reason why the man who directs these powerful 
forces should not be ''straight as a soldier''? 

Those who are too lazy to take a proper amount 
of exercise are a rather hopeless class. Advice and 
example are alike wasted on them, and they must 
e'en pursue their own slothful mode of life until 
death relieves the community of their cumbersome 
presence. Yet even the apparently hopelessly indo- 
lent do sometimes reform and become both useful 
and ornamental members of society. 

But now for that large class who realize the 
necessity of physical exercise and are willing to 
devote some amount of time and trouble to securing 
it. Many of these have already satisfactorily solved 
the problem, so far as they are individually con- 
cerned, as is evidenced by the constantly increasing 
number of strong, straight young men and women 
whom we nowadays meet on our city streets. 

What exercise can our office men take without 
too great an expenditure of time and money? Of 
course this will vary with different individuals. 
For some gymnasiums, conveniently at hand with 
special instructors in attendance, will answer the 
question. To others perhaps walking may be the 
only available out-of-doors exercise. Walking is 



EXERCISE. 259 

better than nothing, and if the walk is brisk, so that 
quite a swing is given the upper part of the body, 
it may fill the requirements, especially if supple- 
mented by suitable indoors work. It is advisable 
that there shall be some objective point, some reason 
for the walk, that it may seem less like a mere task, 
or a tread-mill sort of drudgery. Meals may be 
taken at some distance from the lodging room, or 
the noonday lunch may be made the occasion for 
a moderate amount of exercise. Or there may be 
some park at such distance from the ordinary haunts 
that it requires much pedal exercise to reach it, 
and then a good rest out of doors may be enjoyed 
before the homeward trip. 

Whenever out-of-doors exercise is of such limited 
description, indoor work for the upper part of the 
body should be made use of. Dumb bells, Indian 
clubs and whole hosts of patent exercisers give 
much choice along these lines. See to it that this 
exercise be not too heavy for the muscular develop- 
ment of the individual who is using it, or it may 
work harm rather than good. Do not try to emu- 
late the feats of some friend who ^^never touches 
a dumb bell under ten pounds,'' when very likely 
a two-pound bell should be your limit. Also when 
indoors exercise must be taken, let it approximate 
out-of-doors work as nearly as is practicable. 
Throw open doors and windows, or, still better, 
take your apparatus out on the porch or into the 



26o COLDS^ COUGHS AND SORE THROATS. 

yard, under a tree or other place where it really 
becomes out of doors. 

The bicycle has opened a wide field for those 
who desire invigorating out-of-doors exercise, and 
it has the great advantage of carrying you swiftly 
from the city streets. Bicycling clubs are often 
formed, and the larger enjoyment of a shared 
pleasure comes to those who thus unite. For those 
who live near a river or lake, there are the vigorous 
and enjoyable exercises that may be derived from 
boating. Canoes, row-boats and sailing vessels — 
all are at command. And here again a number of 
persons of like tastes can much increase their facili- 
ties and their enjoyment by combining together for 
that purpose. If there be good swimming and bath- 
ing places near at hand, these sports offer healthful 
exercise to any degree. 

A suburban home affords abundant and varied 
opportunity for physical exercise. Gardening alone 
will engross one man's attention and give him all 
sorts of exercise and any amount thereof. Another 
adds the care of chickens to his scope of labor, 
and perhaps keeps a horse and cow. Indeed, more 
often the suburbanite complains of a superabund- 
ance of exercise than of the reverse condition. 

The possibility of over-exercising is to be guard- 
ed against with much care. Physical directors of 
gymnasiums, who are supposed to be thoroughly 
posted on such matters, have frequently over-exer- 



EXERCISE. 261 

cised frail young men to such degree as to bring on 
severe sickness, simply because they did not recog- 
nize the fact that a fair amount of exertion for a 
robust and well developed youth may prove a bur- 
den far too heavy for weaker and smaller lads, 
even though they may be of the same age. And not 
infrequently some enthusiastic advocate of exercise 
draws the conclusion that if a moderate amount of 
exertion is good, a greater amount is correspond- 
ingly beneficial. Acting on this conviction he over- 
exercises, becomes unnecessarily fatigued, and in 
disgust concludes that physical exercise was not his 
need and gives it all up. Keep well within your 
limitations in this respect, and if it be considered 
desirable to increase the amount of exercise, be con- 
tent to increase it by very slow degrees. 

So long as a man eats well, sleeps well and 
generally enjoys life, there is no danger that he is 
overdoing physical exercise. If, on the contrary, 
after severe muscular exertion, appetite fails, sleep 
is restless and broken and there is general nervous- 
ness and unrest, try less exercise and note if there 
is improvement. And always, when an unusual 
amount of exercise has been taken, whether volun- 
tarily or through force of circumstances, it is a wise 
plan to put in a good deal of time immediately 
thereafter in the most perfect rest practicable, lying 
down if much exhausted, reclining in an easy chair, 
or otherwise taking life easy. If, however, the tired 



262 COLDS^ COUGHS AND SORE THROATS. 

feeling is an habitual condition and no extra exer- 
tion has been made that warrants it, try a httle 
more exercise or consult a physician. 

The proper amount of rest is often of fully as 
much importance as a proper amount of exercise. 
Do not be afraid of lying down in the day time if 
conditions permit. Rather if rest seems needed 
arrange if you can to have a couch or cot where 
you can secure its use, and take all the rest you feel 
any desire for. Or have an easy chair handy and 
see to it that it serves the purpose for which it was 
intended. In olden days an after-dinner nap was a 
frequent custom, and those who thus indulged 
themselves were usually vigorous and healthful 
individuals. 

The importance of comfortable, well ventilated 
sleeping rooms, screens or mosquito bars to prevent 
annoyance by insect pests, and all other means for 
securing peaceful and uninterrupted repose at 
proper times should be fully recognized and acted 
upon. Especially with growing children should 
this matter of adequate rest, as well as an abundance 
of healthful exercise, be given due consideration. 
Very often a rapidly developing child is reproved 
for lying on the floor, or adopting a slouchy atti- 
tude, when there is real need for rest and when 
it would be wiser to advise taking a quilt or blanket 
into a quiet room or under some shady tree and 
indulging in a good nap. 



EXERCISE. 263 

Children require more exercise, proportionately, 
than grown people, and as a rule are very keen 
to take it. If time and opportunity are afforded 
them they will usually select their own sports with 
very good judgment, and take the full measure of 
muscular exertion needed. Very often with chil- 
dren in a city the choice lies between exercise on 
the public streets, with their questionable associa- 
tions, or an unhealthful amount of confinement in- 
doors. It is a hard alternative and one in which 
advice is not easily given. Where there are public 
playgrounds, or the privilege of playing in the 
parks is accorded the young, there is much less 
difficulty, and such conditions should be encouraged 
to the fullest limits. 

In choosing your exercise, select some form in 
which a lively interest can be taken. If daily exer- 
cise is carried through dully and as a matter of 
routine, being regarded as merely so much labor 
to be performed, it is apt to become an unpleasant 
duty, and as such is soon shirked or in some manner 
evaded. Even if the sense of duty prevails and the 
task is grudgingly carried through, much of enjoy- 
ment is lost, and a goodly portion of the benefit is 
missed. The hardest labor becomes easy when per- 
formed with zest and interest, and the lightest ex- 
ercise becomes hard and disagreeable when opposite 
conditions prevail. There are so many forms of 
exercise that among them any one should be able 



264 COLDS^ COUGHS AND SORE THROATS. 

to select one or more forms that will prove enjoy- 
able and of keen interest. If, after a time, the 
chosen method palls, another can be taken, though 
too much changing in this respect is not advisable. 

And always in choosing your exercise select some 
form that will allow of upright bodily carriage and 
abundant breathing capacity. Then see to it that 
the breathing capacity is used aright and that the 
lungs are fully and frequently expanded with the 
purest air that can be drawn into them. Walking, 
if properly performed, demands the upright posi- 
tion, with shoulders well back and chest out. In 
bicycling the position should approximate that of 
the cavalry soldier. The scorcher's position, hump- 
ed over the handle bars like a monkey on a pole, 
largely detracts from the healthfulness of the 
pastime, to say nothing of appearances and the 
effect on habitual posture. Rowing, while it con- 
tracts the chest on the forward reach, yet expands 
it grandly toward the end of the stroke. Those who 
row should, however, be especially careful of posi- 
tion at other times. Horseback riding, ball playing 
and most of the field games call for upright bodily 
carriage, and this should be one of the points most 
carefully attended to in all exercise. 

Breathing exercises alone are fine training for 
many people, and while requiring but little time, 
they yield most excellent results. Dr. Hare, in his 
work on therapeutics, handles this subject in such 



EXERCISE. 265 

masterly style that we cannot do better than to 
quote from him in regard to this matter. He says : 

'' The first form of inhalation to be studied is 
that which is devoted to proper respiratory exer- 
cises. These exercises are required by patients who 
because of faulty development do not properly ex- 
pand certain portions of the chest in the function 
of respiration and by those who have acquired im- 
paired respiratory movements by the following of 
certain occupations, or as a result of attacks of 
disease. 

'' There can be no doubt that pulmonary tuber- 
culosis may be prevented, or even arrested in its 
early stages, by causing a patient to use proper 
thoracic exercises, which must usually be directed 
toward producing expansion of the apices of the 
lungs, a part of these organs which in many in- 
stances is but poorly filled and equally ineffectively 
emptied under ordinary conditions of life. The 
following inhalation exercises are to be directed 
for such cases : 

'' The patient stands with his back against the 
wall, holding himself as erect as possible and bring- 
ing his shoulder blades flat against the plane behind 
him. He now takes a slow, deep and full inspira- 
tion, drawing the air into the chest in a steady 
stream, and not by a sudden jerk of his respiratory 
muscles. The inspired air is then to be held in the 
chest while the patient mentally counts three, and 



266 COLDS, COUGHS AND SORE THROATS. 

then allowed to escape gradually, and not be forced 
out of the chest by sudden muscular effort. Usually 
four or five such movements night and morning 
are quite sufficient for good results for the first 
week. After that they may be gradually increased 
in number. 

* 'Another movement may be added to that just ^ 
described. The patient, standing with his back 
against the wall and the shoulders well thrown 
back, raises his arms, which are completely extend- 
ed, from his sides until the hands are on a level 
with the shoulders, thereby fully expanding the 
sides of the chest. As expiration begins the arms 
are allowed to fall gradually to the sides. After 
this the arms may be carried above the head into 
a perpendicular position. 

''A third exercise consists in inhaling as deeply 
as possible and then exhaling against resistance 
produced by closing the lips and forcing the air 
between them. 

" The fourth exercise consists in lying down upon 
a firm bed with a small pillow under the hollow 
of the back and no pillow under the head, and then 
taking slow, long-drawn inspirations and expira- 
tions as already described. 

'' These exercises are not only useful in persons 
with faulty chest development, but in those who 
have poor expansion of a lung after pneumonia, 
pleurisy or empyema. 



EXERCISE. 267 

" The increase in the volume of air respired under 
gentle but persistently taken exercises of this char- 
acter is quite remarkable, and they often increase 
the appetite, the quantity of haemoglobin, and the 
general health of the patient." 

This closing remark shows plainly that Dr. Hare 
considers these respiratory exercises as exercises 
in every sense of the word. If we can increase the 
appetite and general health and improve the quality 
of the blood, we have accomplished about what 
our exercise is intended for. That such exercises 
are particularly beneficial to those predisposed to 
consumption does not detract from their usefulness 
to others. 

There is also a phrase in the above quotation to 
which we would call especial attention. It is, **Un- 
der gentle but persistently taken exercises.'' Per- 
sistence is what counts, in exercise or any other 
worthy undertaking, and it is for lack of this quality 
that so many fail of the full benefits of exercise. 
If for one reason at one time, and another reason 
at another time, the exercise is shirked or post- 
poned, in many cases it will finally be entirely neg- 
lected, and exercise for health will become a mere 
memory of the past. 

To recapitulate : A certain amount of muscular 
exertion is essential to the maintenance of good 
health. If the business in which you are engaged 
does not furnish sufficient exercise to meet this 



268 COLDS^ COUGHS AND SORE THROATS. 

demand, join a gymnasium or choose some agree- 
able pastime or pursuit of such nature that the 
deficiency is supplied. In selecting exercise, select 
some form that is agreeable and in which you can 
take a lively interest. Let the exercise chosen al- 
ways be of an out-of-doors nature if possible. If 
this is not possible, throw doors and windows wide 
open and approximate the out-of-doors condition 
as nearly as may be. Whenever practicable associ- 
ate yourself with others of like habits and tastes. 
By thus combining, enjoyment is enhanced and 
greater benefits are secured. Find out by experi- 
ment what amount of exercise is required in your 
own individual case, then stick to it persistently 
and steadily. And finally, supplement exercise by 
an abundance of rest. 



CHAPTER XXL 
Clothing, Bathing and Sleep. 

Clothing. Here, as elsewhere, each person must 
make use of his own common sense, and adapt his 
raiment to his own particular needs. There are no 
general rules that will suit all persons alike. Woolen 
underwear is undoubtedly the best for those who 
can wear it with comfort, but many cannot. Pro- 
bably mixed goods, containing cotton and wool in 
varying proportions and often sold as ^^strictly all 
wooV^ suit the greatest* number. Cotton and linen 
goods make delightfully cool underwear but quickly 
grow cold and clammy if perspiration is at all con- 
siderable. Generally speaking, comfort is a pretty 
good guide. If your garments keep you warm in 
winter and allow you to keep reasonably cool in 
summer, if they fit well and feel all right, it is pro- 
bable that you have about what you need. 

Children who are too small to express their dis- 
comfort or too young to have their protests heeded 
are apt to be sufferers, especially in warm weather. 
Many a time the doctor is called to see a sick infant 
and finds it swathed in layer upon layer of warm, 
close-wrapped clothing, with often a shawl or other 
wrap over all, beads of perspiration covering its 

269 



270 COLDS^ COUGHS AND SORE THROATS. 

face, and the rest of its body bathed in warm, un- 
healthful moisture. The doctor has the clothing 
removed, the fevered body bathed in tepid water, 
and one or two abundantly sufficient wraps replace 
the pile of swaddling clothes, whereupon baby falls 
peacefully asleep. Then, likely as not, the anxious 
mother would cover it with a heavy quilt or blanket 
did not the doctor interfere. So the parents pay a 
doctor's fee for a lesson in the very rudiments of 
common sense, and if they lay it to heart the money 
could not be spent to better advantage. 

As cold weather draws on it is the older children 
who fall victims to a lack of ordinary judgment, 
or to false ideas as to toughening them. With the 
grown folks wearing a grade or two heavier under- 
wear than they found comfortable in summer, the 
boy or girl of six or eight years still goes bare 
armed and bare legged, and with scanty covering 
for the rest of the body. Of course this is all 
wrong, and when the older members of the family 
don heavier garments the children should be looked 
after, too. The idea of hardening a child by ex- 
posing it to greater cold than its parents can bear 
with safety is as mistaken as it is cruel, and can- 
not be too severely reprehended. It is far more 
likely to lay the foundations of future illness, or 
cause an early death. 

There are some who advocate the same weight 
of underwear the year around. We cannot believe 



CLOTHING, BATHING AND SLEEP. 27I 

this to be other than a mistaken and harmful idea. 
It is largely based on the fact that our living and 
ofifice rooms are kept at too high temperatures dur- 
ing the colder parts of the year, and that most of 
our time is spent in these overheated rooms. It is 
better to wear somewhat heavier clothing, to spend 
more time out of doors, and to keep the indoors 
temperature at a more healthful degree. 68 to ^2 
degrees Farenheit should be a high enough tem- 
perature for dwelling and business rooms at any 
season of the year, and this will admit of under- 
garments which will be vastly more comfortable 
and healthful when out of doors than our sum- 
mer robing. 

To those who wear chest protectors, we would 
say one word, ''Don't.'' If one is already worn, 
trim it down with the scissors, a little at a time, 
till nothing is left, for any sudden change to much 
lighter wear, even over a limited portion of the 
body, is liable to produce bad results. Too much 
muffling of the neck is another custom to be avoided, 
but, as with the chest protector, the habit is to be 
abolished with caution. If the undershirt is made 
to fit the neck snugly and comfortably, never tightly, 
the need for chest protector or muffler will often 
be done away with. 

For a general rule, be sure that every part of 
your clothing fits well, loosely rather than the con- 
trary, and especially avoid tightness, or constriction 
about the neck, the waist and the feet. 



2.^2 COLDS, COUGHS AND SORE THROATS. 

Baths and Bathing. Baths are a necessity, a 
luxury or a superfluity, according to the views of 
those who indulge therein, or who forego such in- 
dulgence. Civilized people, as a rule, regard them 
as both a necessity and a luxury, but there are 
people, many of whom belong to civilized nations, 
who have as great an aversion to a bath as a cat 
has to a plunge in the creek, and they avoid it with 
equal care. 

The hot, or rather the warm bath, is suited to 
the aged, the very young, and to all who have not 
enough of physical vigor to react promptly and fully 
to the stimulating influence of the cold bath. Its 
great object is cleanliness, and to this end it is 
thoroughly and completely adapted. A large bath 
tub full of comfortably warm water, a good sponge 
or wash cloth, plenty of good soap and clean towels, 
and there you have all the requisites, and can enjoy 
as luxurious a bath as any human being need want. 
But suppose the large bath tub is wanting; does 
that preclude a good warm bath ? Not at all. A 
pitcher of hot water, a wash basin, and sponge, 
soap and towel, will give facilities for as much of 
a bath as is really needed, and in the early days of 
our Republic thousands found these conveniences 
all that was required for personal cleanliness and 
comfort. And, indeed, this is of necessity still true 
in many sections of our country at the present day. 

Those who perform hard physical labor should 



CLOTHING^ BATHING AND SLEEP. 273 

always, when practicable, take a warm bath at the 
close of the working day. With the perspiration 
and grime of the day's toil and exposure removed, 
the surface of the body flushed with invigorated 
blood, and the nervous system calm.ed and soothed, 
the laborer emerges from his bath, a new man 
almost, and life takes on a rosy hue that a few 
minutes before was altogether wanting. 

In the warmer part of the year those who do 
not indulge in cold bathing will find a warm bath 
taken toward the close of the day a very healthful, 
refreshing and comfortable procedure. In colder 
weather many get along with one good bath a 
week. This seems sufficient for health but more 
frequent bathing will certainly do no harm. 

It must not be forgotten, however, that bathing 
may be carried to an extreme, although the reverse 
condition is more frequently encountered. Dr. Hare 
tells us that he has seen cases of nervous exhaustion 
and general loss of vivacity and vitality occur as 
the result of too frequent bathing, and more espe- 
cially so in case of daily bathers who soak them- 
selves in hot or warm fresh water in the morning. 
He also says : 'Tt is proper to call attention to the 
fact that a very large proportion of children who 
are bathed daily are allowed to lie and soak in the 
tub, and as a result become debilitated and fretful, 
only to recover when the bath is used once or twice 
a week, and replaced in the interval by a nightly 



274 COLDS, COUGHS AND SORE THROATS. 

Sponging off with salt and whiskey or salt and 
water." 

The cold bath is one of the greatest tonic agencies 
at our command. It is adapted to all who are 
physically sound and have vitality enough to react 
promptly and fully to the initial shock. The water 
must be cold enough to produce a distinct, though 
not necessarily severe shock, which is evidenced by 
the breath coming in gasps and a primary sensa- 
tion of chill. As nearly as practical the cold water 
should be brought into contact with the whole body 
surface at once, though where adequate means for 
producing this result are lacking, rapid application 
by a large sponge or cloth, frequently wrung out 
and refilled, will give most excellent results. The 
sudden chilling, and consequent contraction of all 
the vessels of the skin sends the surface blood in- 
wards. Then, as the reaction commences, warm 
blood is forced into the surface yessels which are 
filled and expanded, and a sensation of warmth and 
comfort, ''the glow'' is experienced throughout the 
entire system. Thus the functions of the skin are 
stimulated, the circulation toned up, the nervous 
system invigorated and the whole organism re- 
ceives a stimulating and tonic impulse that is of 
the greatest value. The reaction, of which the 
''glow'' is the outward and visible sign, is en- 
couraged and increased by vigorous rubbing with 
a coarse towel, which must immediately follow the 
bath. 



CLOTHING, BATHING AND SLEEP. 275 

A plunge into some almost icily cold mountain 
lake or stream, with perhaps a very short vigorous 
swim, an immediate return to shore, and a brisk 
rubbing down with a coarse towel, would be the 
ideal cold bath. The shower bath is probably the 
next best form for the cold bath, but a bath tub 
full of cold water will furnish a good substitute, 
or a basin with only a quart or two of cold water 
may be made to serve the purpose. Early morning 
is the time for the cold bath, and brisk and thorough 
towel work must immediately follow the plunge. 

With regard to the influence of this process on 
respiratory diseases, let us quote Dr. Harrington. 
He says : ''Not the least in importance of the effects 
of cold bathing is the immunity which its devotees 
appear to enjoy against taking cold. Many of 
those who practice cold bathing the year round 
have no experience whatever with colds, and can 
withstand exposure which, to others, is productive 
of much illness." 

Those in whom the reaction does not occur 
promptly and satisfactorily had better be content 
with warm bathing. And there are many who are 
physically capable of taking the cold bath but who 
lack time, inclination or facilities, who find the 
warm bath sufficient for all their needs, and are 
well content with the cleanly sense of comfort which 
it yields, without striving for any greater degree of 
healthfulness. 



276 COLDS, COUGHS AND SORE THROATS. 

Sleep, For most of us from six to eight, or 
even more hours, of sound refreshing slumber must 
be secured, if possible, out of each twenty-four. 

Supposing then, that any given individual pos- 
sesses a healthy body, a quiet mind and an easy 
conscience; what more is needed to secure this 
g'rand restorer of strength and vigor? In the first 
place a clean and comfortable bed, then a quiet, 
well ventilated room, and the absence of light for 
from six to ten or more hours daily. 

All of the day-time clothing should be removed 
and replaced by suitable night garments on going 
to bed. The form of night robing is of little im- 
portance. That its wearer find it comfortable and 
healthful is the main point to be observed. The 
union suits of underclothing are recommended as 
night garments for children who kick off the cover- 
ings and bunch night robes under the arms, thus 
exposing vital parts to the cold. Woolen night gar- 
ments for those who can wear them with comfort, 
and mixed goods for the rest of us, is probably 
about as near right as we can get in the way of 
fabrics. 

The bed room should, of course, be as quiet and 
well ventilated as possible. Windows should be 
kept open, summer and winter alike, wide open 
for those who can stand it without discomfort, while 
barely open is better than closed. During the 
w^armer portion of the year windows and doors 



CLOTHING, BATHING AND SLEEP. 2^^ 

should always be screened, and the room kept free 
from insect pests of every kind. Wherever prac- 
ticable, each person should have a bed to himself. 
In many cases this is an impossibility, but the single 
bed is far more healthful when it can be secured. 
A separate room to each sleeper is desirable, but 
if ventilation is good, is hardly a necessity. 

And when you go to bed, remember that you 
go there to sleep. Do not allow yourself to fret 
over the worries of the day, the uncertainties of 
the future or the failures of the past. As the aged 
French lady said to her profanely agitated son, a 
lieutenant of the army, hindered by a break down 
on the way to his wedding: ^^Compose yourself, 
my angel, compose yourself.'' 



CHAPTER XXII. 
Conclusion and Conclusions. 

In the standing armies of our great nations, or 
any similar aggregations of men, where each indi- 
vidual must conform to fixed standards as to age, 
height, weight, physical development and bodily 
health, and where all follow much the same mode 
of life, it is quite possible to formulate rules of 
health, by strict enforcement of which a high de- 
gree of vitality may be maintained. In private life 
this is manifestly impossible. The community at 
large comprises individuals of all ages, all condi- 
tions as to health and physical fitness, and all occu- 
pations, habits and modes of life. Hence it comes 
that experience and intelligence will furnish the 
private individual a far better hygiene than any 
he can learn from books, and unless he does sup- 
plement by his own observation and judgment, all 
that the books and the doctors can tell him of the 
rules of health, he will fall short of that degree of 
physical vigor to which he should attain. 

In the preceding chapters the broad rules and 
general principles of hygiene have been given. 
These apply, more or less, to every member of the 
human race, but the particular application rests 

278 



CONCLUSION AND CONCLUSIONS. 279 

wholly with the individual himself. The primary 
principles of hygiene are the same for all. Every 
human being requires an adequate supply of good 
food properly prepared, an abundance of pure air 
and reasonably pure water, with sunshine, exercise, 
recreation and rest in proper amount, and all must 
observe some degree of cleanliness. So far soldier 
and civilian, bookkeeper and trapper, cowboy and 
clerk, are alike in their hygienic requirements. But 
when it comes to the amount and kind of food best 
suited to the needs of each, there is a wide margin 
of difference, and so also of sleep, exercise, cloth- 
ing and all other necessaries of life. The kind and 
amount of food that would suit a cowboy on the 
round-up would be death and destruction to a quiet, 
sedentary bookkeeper, while the cowboy would 
laugh at such rules for exercise as would fit the 
case of the bookkeeper. 

In regard to the effects of different kinds and 
amounts of the requisites of healthful life, each one 
of us has had a lengthy and varied experience, 
numbered as to years by those of our present ex- 
istences, and this experience will continue day after 
day until our sands of life are run and we lose all 
interest in this little one-horse star which people 
call the earth. Can any one ask a finer opportunity 
to study the science of personal hygiene, or the 
rightful use of those things needed in our daily 
lives? It is the merest matter of observation and 
memory. If something we eat disagrees with us, 



28o COLDS, COUGHS AND SORE THROATS. 

or causes sleeplessness or other ill effects, and if 
similar effects follow every time that particular 
article appears on the bill of fare, what more is 
needed to formulate a rule of diet so far as that 
article is concerned. If eight hours of sleep leaves 
us still tired and with a great desire to rest longer, 
it is certainly worth while to try the effect of rising 
a little later or going to bed a little earlier. And 
SO it is all along the line. The general rules of 
hygiene are all right, but if they do not fit your 
own particular case it is your place to so modify 
them that they do fit, and you can do it if you 
choose. 

And, with it all, let your daily lives be cheerful. 
King Solomon said, ''A merry heart doeth good 
like a medicine," and he might have added that it 
doeth it without the disagreeable effects which of- 
ten attend other kinds of medicine. There is a 
hygiene of the mind as well as of the body, and 
what sunshine is to the material part of us cheer- 
fulness is to the mind. Cut out the gloomy recol- 
lections, overlook the minor discomforts, laugh at 
the little annoyances and ignore the trivial and often 
vmintentional slights. The past is gone, the present 
is here, and "de future am a-comin'," and these 
two last named are, and will be, very much what 
you make them. Take a whole lot of interest in 
life, the simple, daily life that is going on right 
now and all about you. It is the best life you know 



CONCLUSION AND CONCLUSIONS. 28 1 

anything about and the more of interest you take 
in it the brighter and more cheerful it will be, and 
the easier to keep in good health and physical vigor. 
And if good health and physical vigor are yours 
you have the best that this world can give, and 
ought to be happy and contented, whether you are 
or whether you are not. At any rate this is our 
conclusion. 



INDEX. 



A. 

Adenoids, 41, 121, 131-134. (See Sore Throat, Ch. VIII.) 
Adrenalin Chloride, 93, 94, 114-116, 139, 140, 204. 
Air, Fresh, 25-27, 32, 33, 61. 

Impure, 41, 42, 43, 105. 
Albolene, 92, 115, 116, 204. 
Albumen, 92, 93. 
Ammonia, 94, 95. 
Anatomy of Larynx, 11, 12. 

Naso-Pharynx, 9, 10, 129, 130. 
Nose, 8, 9. 
Pharynx, 9, 10. 
Throat, 9-11. 
Antiphlogistine, 95. 
Antitoxin, 148. 

Apparatus Used in the Treatment of Respiratory Diseases 
(Ch. V), 76-87. 

Furniture and Utensils, "]"], 78. 

Thermometer, ']'^, 79. 

Hot Water Bottle, 79, 80. 

Ice Bags, 80, 81. 

Compresses, 81. 

Heaters, 81, 82. 

Croup Kettle, 82, 83. 

Bronchitis Tent, 82, 83. 

Inhalation of Steam, 83. 

Inhalers, 84. 

Atomizers, etc., 84, 85. 

Applicators, 85, 86. 

Medicine Droppers, 86. 

Douche Instruments, 86, 87. ^ 

283 



284 INDEX. 

Applicators, 85, 86. 

Asafoetida, 95. 

Atomizers, etc., 84, 85. 

Atropine, 95, 96, 119-121. 

Autumnal Catarrh. (See Hay Fever, Ch. XIV.) 

Avoidance of Infection, 60-62, 65-75. 

B. 

Bacteria, 21, 34, 35, 40, 45-65, 142, I43, 169, 170, 180, 192, 

198, 221. 
Bacteria and Their Relation to Disease (Ch. Ill), 45-62. 
Description of, 45-52. 
Utility of, 52-54. 
Effect of, 53-59. 
Parasitic Bacteria, 54-57. 

Lockjaw, 55, 56. [58-62. 

Relation to Diseases of the Respiratory Tract, 
Action of, 59, 60. 
Infection from, 59, 60. 
Avoidance of, 60-62. 
Bathing, 272-275. 
Breathing, Deep, 126, 238, 239. 
Exercises, 264-267. 
Mouth, 40, 41, 44. 
Bronchitis, 166-178. (See Cough, Ch. XI.) 
Bronchitis Tent, 82, 83, 153, 176, 177. 
Broncho-Pneumonia, 186-190. (See Cough, Ch. XII.) 

C. 

Calomel, 96, 97, 107, 108, 219-221. 

Camphor, 97, 119, 171. 

Cascara Sagrada, 222-224. 

Castor Oil, 97, 109, 225. 

Catarrh, Nasal. (See Cold in Head, Ch. VII.) 

Cathartics, 96, 97, 107-109, 119, 120, 200, 201, 222-225. 



INDEX. 285 

Causes of Bronchitis, 168-170. 

Broncho-Pneumonia, 188. 
Colds, 15, 16, 19-21, 23-44, 105, 10^. 
Coryza, 105, 106. 
Coughs, 13. 
Diphtheria, 142-144. 
Hay Fever, 208. 
La Grippe or Influenza, 198. 
Laryngitis, 137, 138. 
Membranous Croup, 156. 
Naso-Pharyngitis, 130. 
Pharyngitis, 135. 
Pleurisy, 191, 192. 
Pneumonia, 179, 180. 
Sore Throat, 160. 
Whooping Cough, 212. 
Causes of Colds, Coughs and Sore Throats (Ch. II), 23-44. 
Predisposing Causes, 23-34. 

Lowered Vitality, 24, 25, 33. 

Infancy and Childhood, 25. 

Old Age, 25. [s2, 33, 

Neglect of Fresh Air and Sunshine, 25-27, 

Lack of Exercise, 27-29. 

Over-exertion, 28, 32. 

Diet, 29, 30. 

Worry, 30, 31. 

Unsanitary Surroundings, 32-34. 

Self-indulgence, 33. 
Exciting Causes, 23, 24, 34-44. 

Bacteria, 34, 35, 40. 

Exposure, 35-39- 

Mouth Breathing, 40, 41, 44. 

Indigestion and Constipation, 41. 

Impure Air, 41-43. 

Hay Fever, 42. 

Unknown Constituents in Air, 42, 43. 
Resume, 43, 44. 



286 INDEX. 

Chest Protectors, 271. 
Children, 25. 

Adenoids, 131-134. 
Bathing, 272, 273. 
Clothing for, 269, 270. 
Constipation of, 224, 225. 

Diet, 249-251. [232. 

Doses for, 90-92, 94, 96-99, 109, I39, 150, 151, 201, 
Exercise for, 262, 263. 
Tonics for, 121-123. 
Training, 238. 
Clothing, Bathing and Sleep (Ch. XXI), 269-277. 
Clothing, 269-271. 

Underwear, 269-271. 

Children's, 269, 270. 

Chest Protectors, 271. 
Bathing, 272-275. 

Warm Bath, 272, 273. 

Cold Bath, 274, 275. 
Sleep, 276, 277. 

Night Garments, 2'j6. 

Bed Rooms, 276, 2"]^, 
Cod Liver Oil, 121, 122, 134, 210. 
Cold Bathing, 274, 275. 
Cold in the Head (Ch. VII), 104-128. 
Description, 104, 105. 
Causes, 105, 106. 
Symptoms, 106, 107. 
Home Treatment, 107-117. 

Cathartics, 107-109. 

Sweating out, 109-112. 

Use of Adrenalin, 114-116. 

Use of Albolene, 115, 116. 

Headache, 117. 

Summary, 117. 
Traveler's Treatment, 117-121. 

Remedies, 118, 119. 

Treatment, 119-121. 



INDEX. 287 

Cold in the Head. — Continued. 

Persistent Colds, 121-123. 
Children, 121-123. 
Adults, 122, 123. 
Tonics, 121-123. 
Catching Cold Habit, 123, 124. 
Irregular Treatment, 124-126. 

One Day Cold Cures, 124, 125. 
Stocking Cure, 125, 126. 
Deep Breathing, 126. 
Heating Back, 126. 
Summary, 126-128. 

Home Treatment, 127. 
Traveler's Treatment, 127. 
Colds, Causes of, 15, 16, 19-21, 23-44, 105, 106. 
Description of, 12, 15, 16, 104, 105. 
Persistent, 121-123. 
Prevention of, 19. 
Treatment, 17, 18, 22, 107-121. 
Varieties of, 13, 14. 
Compound Cathartic Pills, 97. 
Compresses, 81, 117, 185. 

Conclusion and Conclusions (Ch. XXII), 278-281. 
General Rules, 278-280. 
Individual Variations, 279, 280. 
Cheerfulness, 280, 281. 
Constipation, 41, 107, 201, 218-225. [IV.) 

Contagious Diseases. (See Infectious, etc., Diseases, Ch. 
Coryza. (See Cold in the Head.) 
Coryza Tablets, 95, 96, 118-121. 
Cough, Causes of, 13. 

Description, 13. [Ch. XV.) 

Whooping, 211-217. (See Whooping Cough, 
Cough (Cold on Chest), (Ch. XI), 166-178. 
Bronchitis, 166-178. 

Description, 166-168. 

Trachea and Bronchi, 167, 168. 



288 INDEX. 

Cough (Cold on the Chest). — Continued. 

Causes, 168-170. 

Bacteria, 169, 170. 

Symptoms, 170. 

Course of Disease, 170, 171. 

Treatment, 171-178. 

Bronchitis Tent, 176, 177. 

Croup Kettle, 177, 178. 

Summary, 178. 
Cough (Cold on Chest, Severer Forms), (Ch. XII), 179-196. 
Pneumonia (Lobar), 179-186. 

Description, 179. 

Causes, 179, 180. 

Symptoms, 179, 181-183. 

Treatment, 183-186. 
Broncho-Pneumonia, 186-190. 

Description, 186-188. 

Causes, 188. 

Symptoms, 188. 

Treatment, 189, 190. 
Pleurisy, 190-196. 

Description, 190, 191. 

Causes, 191, 192. 

Symptoms, 192-194. 

Treatment, 194, 195. 
Summary, 195, 196. 
Croup Kettle, 82, S3, 157, I77, 178. 
Croup, Membranous, 156-158. 
Cure or Prevention of Hay Fever, 209. 

D. 

Deep Breathing, 126, 238, 239, 264-267. 

Diarrhoea, 226. 

Diet, 29, 30. (See Food, Ch. XIX.) 

in Colds and Sore Throat, 140, 141. 

Diphtheria, 149, 150. 

Fever, 234, 



INDEX. 289 

Diet. — Continued. 

La Grippe, 203. 
Tonsillitis, 164, 165. 
Whooping Cough, 215, 216. 
Diphtheria, 142-156. (See Sore Throat, Ch. IX.) 

Laryngeal Form, 147, 153, 154. 

Nasal Form, 147, 148, 154, 155. 

Pharyngeal Form, 145, 146, 152. 
Disinfectants, 74, 75. 
Disinfection, 71-75. 

Doctor, When to send for, 17-19, 148, 176, 178. [VL) 

Doses. (See Medicinal Remedies and Their Doses, Ch. 
Douche Instruments, 86, 87. 

Dovers' Powders, iii, 113, 118, 120, 127, 171, 184. 
Droppers, Medicine, 86, 116. 

E. 
Epsom Salts, 97, 102, 108. 
Eustachian Tubes, 10, 130. 

Exciting Causes of Colds, Coughs, etc., 2^, 24, 34-44. 
Exercise, 27-29, 253-268. 
Exercise (Ch. XX), 256-268. 

Modern Practice, 256-258. 

Suggestions as to Exercise, 258-260. 

Over-exercise, 260-262. 

Rest and Sleep, 262. 

Children's Exercise, 262, 263. 

Forms of Exercise, 263, 264. 

Breathing Exercises, 264-267. 
Exposure as Cause of Disease, 28, 35-39, 43, 44, 105, 106. 

F. 
Fever, 227-234. 

Hay, 16, 42, 207-210. 
Fever Powders, 97, 98, 233. 
Flaxseed Tea, 98. 
Food (The Food We Eat, Ch. XIX), 248-255. 

Varieties, 248. 

General Principles, 249. 



290 INDEX. 

Food (The Food We Eat). — Continued. 

Diet for Children, 249-251. 

Diet for Adults, 251-253. 

Good Cooking, 253. 

Exercise, 253-255. 
Foot Bath, Hot, 109-112, 171. 

Fresh Air and Sunshine, Neglect of, 25-27, 32, :^:^, 61. 
Fresh Air and Sunshine (Ch. XVIII), 235-247. 

Hygiene, 235-237. 

Necessity of, 237. 

Training Children, 238. 

Deep Breathing, 238, 239. 

Ventilation, 239-241. 

Healthful Arrangements, 241-244. 

Sanitary Conveniences, 244-246. 
Furniture and Utensils, 77, 7S. 

G. 

General Treatment (Ch. XVI), 218-226. 
Constipation, 218-225. 
Dangers of, 218, 219. 
Use of Calomel, 219-221. 
Intestinal Antiseptics, 221, 222. 
Use of Cascara Sagrada, 222-224. 
Other Laxatives, 224, 225. 
Children, 224, 225. 
Diarrhoea, 226. 
General Treatment (Ch. XVII), 227-234. 
Fever, 227-234. 

Symptoms, 227. 
Treatment, 227-234. 

Use of Water, 227-232. 
Other Remedies, 232, 233. 
Bedding, 233, 234. 
Diet, 234. 
Germs. (See Bacteria.) 
Gum Guaiac, 98, 137, 163. 



INDEX. 291 

H. 

Hay Fever, 16, 42, 207-210. 
Hay Fever (Ch. XIV), 207-210. 

Description, 207, 208. 

Causes, 208. 

Symptoms, 208, 209. 

Cure or Prevention, 209. 

Treatment, 209, 210. 
Headache, 117. 
Heaters, 81, 82. 

Home Treatment, 17, 18, 22, 107-117, 127, 194, 195. 
Hot Water Bottle, 79, 80. 
Hygiene (Part III), 235-281. 

I. 

Ice Bags, 80, 81. 

Impure Air, 41-43, 105. 

Indigestion and Constipation, 41. 

Infants, 25. 

Infection, Bacterial, 20, 21, 59, 60, 63-65, 188. 

Avoidance of, 60-62, 65-75. 
Infectious and Contagious Diseases (Ch. IV), 63-75. 
Description, 6^. 
Incubation, 64. 
Effects, 64, 65. 
Avoidance of, 65-75. 

Respiratory Diseases, 66, 67. 
Rules for, 68-75. 
Methods of Disinfection, 71-73. 
Disinfectants, 74, 75. 
Influenza, 197-206. (See La Grippe or Influenza, Ch. XIII.) 
Inhalation of Steam, 83, 172, 204. 
Inhalers, 84. 
Iron, 99, 121-123, 134, 150, 151, 210. 

J. 



292 INDEX. 

K. 

L. 

La Grippe or Influenza (Ch. XIII), 197-206. 
Description, 197-199. 
Causes, 198. 
Symptoms, 198, 199. 
Treatment, 199-204. 
Preliminary, 200. 
For Constipation, 201. 
For Fever, 202. 
Tonics, 203. 
Diet, 203. 
Prevention, 205. 
Laryngeal Diphtheria, 147, 153, 154. 
Laryngitis, 137-140. 
Larynx, Anatomy of, 11, 12. 
Liquid Vaseline. (See Albolene.) 
Lockjaw, 55, 56. 

M. 

Medicinal Remedies and Their Doses (Ch. VI), 88-103. 
Measures and Doses, 88, 89. 
Keeping Medicines, 89, 90. 
Children's Doses, 90-92, 94, 96-99. 
Abolene, 92. 
Albumen, 92, 93. 
Adrenalin Chloride, 93, 94. 
Ammonia, 94, 95. 
Antiphlogistine, 95. 
Asafoetida, 95. 
Atropine, 95, 96. 
Calomel, 96, 97. 
Compound Cathartic Pills, 97. 
Castor Oil, 97. 



INDEX. 293 

Medicinal Remedies and Their Doses. — Continued. 

Camphor, 97. 

Epsom Salts, 97, 102. 

Fever Powders, 97, 98. 

Flaxseed Tea, 98. 

Guaiac, 98. 

Iron, 99. 

Menthol, 99. 

Oils, 99, 100. 

Onions, 100, loi. 

Quinine, loi, 102. 

Salts and Salines, 102. 

Salol, 102. 

Sulphocarbolates, 102, 103. 
Medicine Droppers, 86, 116. 
Membranous Croup, 156-158. 
Menthol, 99, 116. 

Inhalers, 84. 
Microbes. (See Bacteria.) 
Mouth Breathing, 40, 41, 44, 131, 132. 
Mucous Membrane, 8, 166, 168. 

N. 

Nasal Diphtheria, 147, 148, 154, 155. 

Naso-Pharyngitis, 129-131. 

Naso-Pharynx, 9, 10, 129, 130. 

Nebulizers, 84, 85. 

Neglect of Fresh Air and Sunshine, 25-27, s^^ ;^S} 61. 

Nose, Anatomy of, 8, 9. 

O. 

Oils, 99, 100. 

Castor, 97, 109, 225. 

Cod Liver, 121, 122, 134, 210. 
One Day Cold Cures, 124, 125. 
Onions, 100, loi. 



294 INDEX. 

Oro-Pharynx, lo, ii. 
Over-Exertion, 28, 32, 260-262. 

P. 

Parasitic Bacteria, 54-57. 

Pertussis. (See Whooping Cough, Ch. XV..) 

Pharyngeal Diphtheria, 145, 146, 152. 

Pharyngitis, 134-137. 

Pharynx, Anatomy of, 9, 10. 

Pleurisy, 190-196. (See Cough, Ch. XII.) 

Pneumonia, 179-186. (See Cough, Ch. XII.) 

Pocket Inhalers, 84. 

Predisposing Causes of Colds, Coughs, etc., 23-34, 105. 

Prevention of Colds, 19. 

Hay Fever, 209. 

La Grippe or Influenza, 205. 

Q. 

Quinine, loi, 102, 111-113, 120, 210, 216. 
Quinsy, 160, 161. 

R. 

Ragweed Fever. (See Hay Fever, Ch. XIV.) 

Remedies. (See Medicinal Remedies and Their Doses, 

Ch. VI.) 
Remedies, Traveler's, 118, 119. [234. 

Respiratory Diseases and Their Treatment (Part II), 104- 
Respiratory Tract and Its Diseases (Ch. I), 7-22. 
Description, 7-12. 
Nose, Anatomy of, 8, 9. 
Throat, Anatomy of, 9-1 1. 

Sore, 12. 
Cold, Defined, 12. 

Varieties of, 13, 14. 
Cough, 13. 

Causes, 13. 



INDEX. 295 

Respiratory Tract and Its Diseases. — Continued. 

Causes of Colds, 15, 16, 19-21. 

Hay Fever, 16. 

Home Treatment of Colds, 17, 18, 22. 

Prevention, 19. 
Rest and Sleep, 262. 

Rhinitis, Acute. (See Cold in Head, Ch, VII.) 
Rose Cold. (See Hay Fever, Ch. XIV.) 



Salol, 102. 

Salts and Salines, 102. 
Sanitary Conveniences, 244-246. 
Self-indulgence, SS- 
Sleep, 262, 276, 277. 
Sore Throat, 12, 129-165. 

Sore Throat (Common Forms), (Ch. Vlll). 129-141. 
Organs Included, 129. 
Naso-Pharyngitis, 129-131. 
Description, 130. 
Causes, 130. 
Symptoms, 130. 
Treatment, 131. 
Adenoids, 131-134. 

Description, 131, 132. 
Symptoms, 131-133. 
Effects, 132, 133. 
Treatment, 133, 134. 
Surgical, 133, 134. 
Medical, 134. 
Pharyngitis, 134-137. 

Description, 134-136. 
Causes, 135. 
Symptoms, 135. 
Treatment, 136, 137. 
Laryngitis, 137-140. 
Description, 137. 



296 INDEX. 

Sore Throat (Common Forms). — Continued. 
Laryngitis. — Continued. 
Causes, 137, 138. 
Symptoms, 138. 
Treatment, 139, 140. 
Diet, 140, 141. 
Sore Throat (Severe Forms), (Ch. IX), 142-158. 
Diphtheria, 142-156. 

Action of Bacteria, 142, 143. 
Causes, 142-1.^4. 

Pharyngeal Form, 145, 146, 152. 
Symptoms, 145, 146. 
Course of Disease, 146. 
Danger from, 146. 
Laryngeal Form, 147, 153, 154. 
Symptoms, 147. 
Danger from, 147. 
Nasal Diphtheria, 147, 148, 154, 155. 
Mild Form, 147. 
Symptoms, 147, 148. 
Danger from, 147, 148. 
Treatment, 148-156. 
Antitoxin, 148. 
Nursing, 148, 149. 
Diet, 149, 150. 
Medicine, 150-155. 
Convalescence, 155, 156. 
Membranous Croup, 156-158. 
Description, 156, 157. 
Causes, 156. 
Symptoms, 157. 
Treatment, 157, 158. 
Sore Throat (Severe Forms), (Ch. X), 159-165. 
Tonsillitis, 159-165. 

Description, 159, 160. 
Forms, 159, 160. 
Causes, 160. 



INDEX. 297 

Sore Throat (Severe Forms). — Continued. 
Tonsillitis. — Continued. 

Symptoms, 160-162. 

Treatment, 162-164. 

Diet, 164, 165. 
Steam, Inhalation of, 83, 172, 204. 
Stocking Cure for Cold, 125, 126. 
Sulphocarbolates, 102, 103. 

Sunshine. (See Fresh Air and Sunshine, Ch. XVIII.) 
Symptoms of Adenoids, 131-133. 

Bronchitis, 170. 

Broncho-Pneumonia, 188. 

Coryza, 106, 107. 

Coughs, 170. 

Diphtheria, Laryngeal, 147. 
Nasal, 147, 148. 
Pharyngeal, 145, 146. 

Fever, 22^. 

Hay Fever, 208, 209. 

La Grippe or Influenza, 198, 199. 

Laryngitis, 138. 

Membranous Croup, 159. 

Naso-Pharyngitis, 130. 

Pharyngitis, 135. 

Pleurisy, 192-194. 

Pneumonia, 179, 181-183. 

Sore Throat, 160-162. 

Whooping Cough, 213, 214. 

T. 

Tablets, Coryza, 95, 96, 118-121. 
The Food We Eat. (See Food.) 
Thermometers, 78, 79. 
Throat, Anatomy of, 9-1 1. 

Sore, 12. (See Sore Throat, Chs.-VIII, IX, X.) 
Tonics, 99, 121-123, 134, 150, 151, 203, 210. 
Tonsillitis, 159-165. ^ 



298 INDEX. 

Traveler's Treatment of Colds, 117-121, 127. 
Treatment, Adenoids, 133, 134. 

Apparatus Used in, 76-87. 
Bronchitis, 171-178. 
Broncho-Pneumonia, 189, 190. 
Constipation, 128-225. 
Colds, 17, 18, 22. 
Coryza, 107-121. 
Cough, 172-174. 
Diarrhoea, 226. 
Diphtheria, 148-156. 
Fever, 227-234. 
Hay Fever, 209, 210. 
Home, 17, 18, 22, 107-117, 127, 194, 195. 
La Grippe or Influenza, 199-204. 
Laryngitis, 139, 140. 
Membranous Croup, 157, 158. 
Naso-Pharyngitis, 131. 
Pharyngitis, 136, 137. 
Pleurisy, 194, 195. 
Pneumonia, 183-186. 
Tonsillitis, 162-164. 
Traveler's, 117-121, 127. 
Whooping Cough, 214-217. 
Treatment, General (Ch. XVI), 218-226. 
Constipation, 218-225. 

Dangers of, 218, 219. 

Use of Calomel, 219-221. 

Intestinal Antiseptics, 221, 222. 

Use of Cascara Sagrada, 222-224. 

Other Laxatives, 224, 225. 

Children, 224, 225. 
Diarrhoea, 226. 
Treatment, General (Ch. XVH), 227-234. 
Fever, 227-234. 

Symptoms, 22"]. 

Treatment, 227-234. 



INDEX. 299 

/ 

Treatment, General. — Continued. 
Fever. — Continued. 

Treatment. — Continued. 

Use of Water, 227-232. 
Other Remedies, 232, 233. 
Bedding, 233, 234. 
Diet, 234. 
Treatment of Respiratory Diseases, Apparatus Used (Ch. 
V), 76-87. 
Furniture and Utensils, '/T, 78. 
Thermometer, ^%, 79. 
Hot Water Bottle, 79, 80. 
Ice Bags, 80, 81. 
Compresses, 81. 
Heaters, 81, 82. 
Croup Kettle, 82, 83. 
Bronchitis Tent, 82, 83. 
Inhalation of Steam, 83. 
Inhalers, 84. 
Atomizers, etc., 84, 85. 
Applicators, 85, 86. 
Medicine Droppers, 86. 
Douche Instruments, 86, 87. 
Turpentine, 139. 

U. 

Underwear, 269-271. 
Unsanitary Surroundings, 32-34. 

V. 

Vaporizers, 84, 85. 
Vaseline, Liquid. (See Albolene.) 
Ventilation, 25-27, 32, 239-241, 276. 
Vitality, High, z^, 27, 44- 

Lowered, 24, 25, Z3, 105, I43, 160, 168, 179, 212, 273. 



300 INDEX. 

W. 

Warm Bathing, 272, 273. 

When to Send for Doctor, 17-19, 148, 176, 178. 

Whooping Cough (Pertussis), (Ch. XV), 211-217. 

Description, 211, 212. 

Danger of, 212. 

Causes, 212. 

Symptoms, 213, 214. 

Treatment, 214-217. 

Diet, 215, 216. 

Remedies, 216, 217. 
Worry, 30, 31. 



OCr 8 i9^6 



